JP7398378B2 - End effector and method for driving tools guided by a surgical robotic system - Google Patents

Description

[Cross reference to related applications]
This patent application is filed under U.S. Provisional Patent Application No. 62/622,306 filed January 26, 2018 and U.S. Claims priority and interest in Provisional Patent Application No. 62/744,878.

Surgical robotic systems are often used to assist medical personnel in performing various types of surgical procedures. To this end, surgeons may use surgical robots to guide, position, move, actuate, or otherwise manipulate various tools, components, prostheses, etc. during surgery.

It will be appreciated that surgical robots can be used to assist surgeons in performing several different types of surgical procedures. By way of illustration, surgical robots can correct, stabilize, or stabilize one or more parts of a patient's body, such as to help improve patient mobility, reduce pain, reduce the risk of subsequent injury or damage, etc. Commonly used in procedures involving conversion, excision, or replacement.

As an illustrative example, in many types of spinal procedures (e.g., posterior pathway lumbar interbody fusion "PLIF"), a robotic system advantageously performs lumbar lamina at discrete locations within the vertebrae of a patient's spine. Helps facilitate proper placement of root screws. Pedicle screws act as fixators and typically work in conjunction with additional fixation hardware (e.g., stabilizing rods) to limit movement between the fixed vertebrae, thereby allowing adjacent vertebrae to It helps to ensure that the intervening bone graft can be successfully fixed together.

When a patient requires surgery involving the placement of pedicle screws, preoperative and/or intraoperative imaging may be performed by the surgeon to help visualize the patient's anatomy (e.g., the vertebrae of the patient's spine). often used by. Surgeons typically plan where to place pedicle screws based on preoperative imaging, such as images captured of the patient's anatomy and 3D models created from the images. Planning determines the desired position and orientation (i.e., posture) of each pedicle screw relative to the particular vertebra in which it is to be placed, such as by identifying the desired posture in preoperative images and/or a 3D model. ). Once set, the plan is communicated to the robotic system for execution.

Typically, the robotic system comprises a surgical robot having a robotic arm that moves the tool over the patient along a desired trajectory aligned with the desired orientation of the pedicle screw to be placed. Position the guide. The robotic system also includes a navigation system for determining the position of the tool guide relative to the patient's anatomy so that the robotic arm can position the tool guide along a desired trajectory according to the surgeon's plan. In some cases, the navigation system includes a surgical robot and a tracking device attached to the patient's body, such that the robotic system dynamically moves the tool guide as necessary to maintain the desired trajectory. This allows movement during a surgical procedure to be monitored and responded to.

In minimally invasive surgical techniques, after the tool guide is aligned with the desired trajectory, the surgeon generally positions the cannula with the tool guide extending into an incision made in the patient's body adjacent to the vertebrae at the surgical site. . The surgeon then attaches a drill bit to a handheld drill, inserts the drill bit into the cannula, and activates the drill to form a pilot hole for the pedicle screw. The surgeon then installs the pedicle screw into the vertebra by removing the drill bit and then driving the pedicle screw into position within the pilot hole by the hand-held power transmission.

In spinal surgical techniques of the type described above, robotic arms are underutilized and have little or no involvement in forming pilot holes or actually placing pedicle screws. Additionally, despite the benefits offered by the ability of a surgical system to maintain trajectory, traditional minimally invasive techniques do not allow for multiple positions of the robotic arm when placing a single pedicle screw. Often needs to be changed. The frequency and extent of this repositioning depends on, among other things, the specific type of surgical technique being utilized, surgeon preference, and the configuration of the pedicle screws, guide tools, drills, and surgical robot itself.

Additionally, multiple pedicle screws are typically placed during a single procedure (e.g., a left and right interbody fusion of two adjacent vertebrae often involves a total of four pedicle screws). ), which can make it difficult to efficiently articulate the robotic arm between different trajectories without interfering with the surgeon's technique. Additionally, in some situations, when it is not possible to perform the required articulation movements of the robotic arm to achieve between different trajectories and/or to provide the surgeon with a consistent approach along each trajectory, the surgical The robot itself may need to be repositioned relative to the patient's body.

Accordingly, there remains a need in the art to address one or more of these issues.

The present disclosure provides an end effector that drives a tool at a surgical site along a trajectory maintained by a surgical robot. The end effector includes a fixture adapted to be attached to a surgical robot and a rotary instrument coupled to the fixture and comprising an actuator configured to generate a rotational torque about a first axis. . The end effector also includes a gear train that converts rotation from the rotating equipment into rotation about a second axis that is different from the first axis, and a gear train that releasably secures the tool for rotation about the second axis. a drive assembly having a connector configured to. The end effector also includes a handle assembly having a grip that supports a user's hand and an input handle that interfaces with the rotating equipment. The input manipulator is arranged to, when engaged by a user, drive the rotary instrument to rotate the tool about the second axis. The end effector also includes a manual interface that interfaces with the drive assembly. The manual interface is arranged to receive applied force from a user and convert it into rotational torque for rotating the tool about the second axis.

The present disclosure also provides an end effector that drives a tool at a surgical site along different trajectories that are selectively maintained by a surgical robot. The end effector includes a fixture adapted to be attached to a surgical robot and a rotary instrument coupled to the fixture and comprising an actuator configured to generate a rotational torque about a first axis. . The end effector also includes a gear train that converts rotation from the rotating equipment into rotation about a second axis that is different from the first axis, and a gear train that releasably secures the tool for rotation about the second axis. a drive assembly having a connector configured to. A coupler is operably attached to the rotating instrument, the coupler coupling the drive assembly to selectively position the second axis relative to the rotating instrument along different trajectories maintained by the surgical robot. Configured to releasably secure to rotating equipment in multiple orientations.

The present disclosure also provides an end effector for driving a tool at a surgical site along a trajectory maintained by a surgical robot, the tool having an interface end and a working end. The end effector includes a fixture adapted to be attached to a surgical robot and an actuator coupled to the fixture and configured to generate rotational torque about a first axis. The end effector also includes a drive assembly that rotates about the second axis and a gear train that converts rotation about the first axis from the actuator into rotation about the second axis. a first rotational lock operatively attached to the drive conduit to releasably secure the tool for simultaneous rotation about a second axis; and an axial stop that releasably secures the tool for simultaneous translation with the drive conduit along a trajectory maintained by the robot. The axial catch has a release configuration that allows for relative movement between the drive assembly and the tool along the second axis, and a release configuration that allows for relative movement between the drive assembly and the tool along the second axis. Operable between restricted lock configurations.

The present disclosure also provides an end effector for guiding a tool relative to a surgical site along a trajectory maintained by a surgical robot, the tool including a first tool and a second tool different from the first tool. including tools. The end effector includes a fixture adapted to be attached to a surgical robot and a rotary instrument coupled to the fixture and comprising an actuator configured to generate a rotational torque about a first axis. . The end effector also includes a gear train that converts rotation about the first axis from the rotating equipment into rotation about the second axis, the end effector being rotationally coupled with the gear train to convert rotation about the first axis from the rotating equipment into rotation about the second axis at the first drive ratio. a first rotational stop arranged to releasably secure the first tool for simultaneous rotation about the first tool; a second drive in conjunction with the gear train that is different than the first drive ratio; a second rotational stop positioned to releasably secure the second tool for simultaneous rotation about a second axis at a ratio and driven along a trajectory maintained by the surgical robot; A drive assembly is provided having an axial stop releasably securing one of the first tool and the second tool for simultaneous translation with the assembly. The axial lock has a release configuration that allows for relative movement between the drive assembly and the fixed tool along the second axis and a relative movement between the drive assembly and the fixed tool along the second axis. Operable between locked configurations with limited movement.

The present disclosure also provides an end effector for driving a tool at a surgical site along a trajectory maintained by a surgical robot, the tool having a first tool and a second tool different from the first tool. including. The end effector includes a fixture adapted to be attached to a surgical robot and a rotary instrument coupled to the fixture and comprising an actuator configured to generate a rotational torque about a first axis. . The end effector also includes a gear train that converts rotation from the rotating equipment into rotation about a second axis that is different from the first axis, the first tool and the second tool for rotation about the second axis. a drive assembly having a connector configured to releasably secure one of the tools, and a transmission interposed for rotational communication between the rotating device and the connector. The transmission includes a first gear set, a second gear set, and a conversion collar, the conversion collar engaging the first gear set to connect the rotating equipment and the connector at a first drive ratio. a first collar position for converting rotation between the rotating equipment and the connector, the conversion collar engaging a second gear set to provide a second drive ratio different than the first drive ratio between the rotating equipment and the connector; and a second collar position for rotational transformation.

The present disclosure also provides a method of forming a pilot hole in a surgical site along a trajectory maintained by a surgical robot. The method includes attaching an end effector supporting an actuator, a drive assembly, a manual interface, and a manipulator assembly to a surgical robot. The method also includes attaching a rotary cutting tool to the drive assembly along a second axis, aligning the second axis with a trajectory to position the rotary cutting tool at a surgical site, and a manipulator assembly. to generate a rotational torque about the first axis by the actuator and convert the torque about the first axis from the actuator by the drive assembly to rotate the rotary cutting tool about the second axis. and rotating with. The method also includes advancing a rotary cutting tool along a trajectory at a surgical site to a first depth, ceasing rotation about a first axis, and providing a manual interface to a manipulator assembly. applying a force to the manual interface to rotate the rotary cutting tool about a second axis; and controlling the rotary cutting tool along a trajectory at the surgical site to a second depth greater than the first depth. and advancing to a depth of .

The present disclosure also provides a method of installing a fixture at a surgical site along a trajectory maintained by a surgical robot. The method includes attaching an end effector supporting an actuator, a drive assembly, a manual interface, and a manipulator assembly to a surgical robot. The method also includes attaching the tool to the drive assembly along a second axis, attaching the fixture to the tool, and aligning the second axis with the trajectory to position the fixture adjacent the surgical site. positioning the tool by engaging the handle assembly to generate a rotational torque about the first axis by the actuator and converting the torque about the first axis from the actuator by the drive assembly; and rotating the fixture about the second axis. The method also includes advancing the tool and fixture along a trajectory at the surgical site to a first depth, ceasing rotation about the first axis, and controlling the operating tool to present a manual interface. positioning the assembly; applying a force to the manual interface to rotate the tool and the fixture about a second axis; and moving the fixture along a trajectory at the surgical site to a depth greater than the first depth. and advancing to a depth of 2.

The present disclosure also provides a method of installing first and second fixtures at a surgical site along first and second trajectories, respectively, maintained by a surgical robot. The method includes attaching an end effector supporting an actuator, a drive assembly, a manual interface, and a manipulator assembly to a surgical robot. The method also includes attaching the tool to the drive assembly along a second axis, attaching the first fixture to the tool, and aligning the second axis with the first track so that the first positioning the fixture adjacent the surgical site and engaging the manipulator assembly to generate a rotational torque about the first axis by the actuator and rotating the first axis from the actuator by the drive assembly. transforming the torque about the tool and the first fixture to rotate the tool and the first fixture about the second axis. The method also includes advancing the tool and the first fixture to a first depth along a first trajectory at the surgical site, ceasing rotation about the first axis, and providing a manual interface. positioning the manipulator assembly to present and applying a force to the manual interface to rotate the tool and the first fixture about a second axis and into the first trajectory at the surgical site; and advancing the tool and the first fixture along the depth to a second depth that is greater than the first depth. The method includes releasing a first fixture from a tool, attaching a second fixture to the tool, aligning a second axis with a second track, and moving the second fixture to the tool. positioning adjacent the surgical site; engaging the manipulator assembly to generate rotational torque about the first axis by the actuator; and generating rotational torque from the actuator about the first axis by the drive assembly. and converting the torque to rotate the tool and the second fixture about the second axis. The method includes advancing a tool and a second fixture to a third depth along a second trajectory at a surgical site, ceasing rotation about a first axis, and presenting a manual interface. and applying a force to the manual interface to rotate the tool and the second fixture about a second axis along a second trajectory at the surgical site. advancing the tool and the second fixture to a fourth depth that is greater than the third depth.

Other features and advantages of embodiments of the present disclosure will be better understood and easily appreciated upon reading the following description in conjunction with the accompanying drawings.

1 is a perspective view of a surgical system comprising a surgical robot having a robotic arm supporting an end effector according to a first embodiment of the present disclosure, with a tool fixed along a trajectory adjacent to a surgical site on a patient's body; FIG. be. 2 is a perspective view of the end effector, tool, and portion of the patient's body of FIG. 1 showing the tool supported along a first trajectory; FIG. 2B is another perspective view of the end effector, tool, and patient's body portion of FIG. 2A showing the tool supported along a second trajectory; FIG. 2B is another perspective view of the end effector, tool, and patient body portion of FIGS. 2A-2B showing the tool supported along a third trajectory; FIG. a fixture that supports a rotating equipment to generate a torque about a first axis and has a coupler; and a fixture that is attached to the coupler of the rotating equipment and supports a tool for rotation about a second axis. a drive assembly having a grip and an input control, the input control being arranged to drive the rotating equipment when engaged by a user; 2C is a perspective view of the end effector of FIGS. 1-2C showing the end effector with a manual interface for rotation about a second axis and a handle assembly that engages the manual interface. FIG. The drive assembly is spaced from the rotating equipment below the handle assembly and is spaced from two tools configured to be releasably attached to the drive assembly, one of the tools being spaced apart from the rotating equipment and configured to be releasably attached to the drive assembly; 4 is a partially exploded perspective view of the end effector of FIG. 3 shown as a rotary cutting tool with a bit, the other of the tools being shown as a rotary drive tool supporting a fixture; FIG. first and second trajectories are shown disposed bilaterally with respect to the spinous process and extend into the vertebral body through the respective pedicles on either side of the vertebral foramen and spinal cord; 1 and a drill bit guided along a second trajectory positioned adjacent to a vertebra. FIG. 2 is an illustration of a surgical site in a transverse section of a patient's vertebrae associated with a minimally invasive spinal fusion technique. Another surgical site in FIG. 5A showing the drill bit forming a first depth pilot hole extending through the vertebra along a second trajectory and into the vertebral body through the pedicle. FIG. 5A-5B is another illustration of the surgical site of FIGS. 5A-5B showing the drill bit further advanced along the trajectory to further form a second depth pilot hole into the vertebral body; FIG. 5A-5C showing the drill bit removed from the pilot hole and the fixator supported by a rotary drive tool guided along a second trajectory positioned adjacent the vertebrae; FIG. FIG. 2 is another explanatory diagram of the surgical site. 5A-5D is another illustration of the surgical site of FIGS. 5A-5D showing the fixator being installed into the vertebra along a second trajectory to a third depth; FIG. 5A-5E is another illustration of the surgical site of FIGS. 5A-5E showing the fixator being installed into the vertebra along a second trajectory to a fourth depth; FIG. 5A-5F is another illustration of the surgical site of FIGS. 5A-5F showing fixators being placed within the vertebrae along their respective trajectories; FIG. 5F is a perspective view of a tool supporting the fixture of FIGS. 1-5F; FIG. 7 is a top view of a tool supporting the fixture of FIGS. 1-6; FIG. 8 is a cross-sectional view taken along line 8-8 of FIG. 7. FIG. 9 is an exploded perspective view of the tool shown spaced apart from the fixture of FIGS. 1-8; FIG. The end of FIGS. 1-4 showing the handle assembly positioned in the first handle assembly position, with the grip and input handle positioned adjacent the drive assembly and above the manual interface. FIG. 3 is a perspective view of an effector. FIG. 10A shows the handle assembly positioned in a second handle assembly position and the grip and input handle moved to present a manual interface for engagement by the handle assembly. FIG. 3 is another perspective view of the end effector. 10B is a front view of the end effector of FIGS. 10A-10B with the handle assembly positioned in a first handle assembly position and the coupler supporting the drive assembly in a first orientation; FIG. . the handle assembly is shown positioned in a second handle assembly position, the coupler supporting the drive assembly in the first orientation, and the handle assembly positioned adjacent the manual interface; 11B is another front view of the end effector of FIG. 11A. FIG. the handle assembly is positioned in a second handle assembly position, the coupler supports the drive assembly in the first orientation, and the handle assembly is positioned to engage the manual interface; 11B is another front view of the end effector of FIGS. 11A-11B. FIG. 11A-11C is another front view of the end effector of FIGS. 11A-11C showing the handle assembly positioned in the first handle assembly position and the coupler supporting the drive assembly in a second orientation; FIG. It is. 11A-11D is another front view of the end effector of FIGS. 11A-11D showing the handle assembly positioned in the first handle assembly position and the coupler supporting the drive assembly in a third orientation; FIG. It is. 11A-11E is another front view of the end effector of FIGS. 11A-11E showing the handle assembly positioned in a third handle assembly position and the coupler supporting the drive assembly in a third orientation; FIG. It is. FIG. 5 is a top view of the end effector fixture, rotary instrument, handle assembly, and coupler of FIGS. 1-4; FIG. 13 is an offset cross-sectional view taken along line 13-13 of FIG. 12. FIG. 14 is an enlarged cross-sectional view taken along mark 14 in FIG. 13. FIG. 14 is an enlarged sectional view taken along mark 15 in FIG. 13. FIG. FIG. 13 is a perspective view of the end effector mount, rotating equipment, handle assembly, and coupler of FIG. 12; FIG. 17 is a partially exploded perspective view of the end effector of FIG. 16 showing the handle assembly, fixture, and retainer each spaced apart from the rotating equipment; FIG. 17 is another partially exploded perspective view of the end effector of FIG. 16 showing portions of the retainer and manipulator assembly, each shown spaced apart from the rotating equipment. FIG. 6 shows a handle assembly disposed in a first handle assembly position, an input handle shown disposed in a first input position, and portions of the handle assembly shown in dashed lines; FIG. 11A is a perspective view of a portion of the retainer and handle assembly of the end effector of FIGS. 11A-18; FIG. 19A shows the handle assembly disposed in a first handle assembly position, the handle assembly is shown disposed in a second input position, and portions of the handle assembly are shown in dashed lines; FIG. FIG. 3 is another perspective view of a portion of the retainer and handle assembly of the end effector of FIG. FIG. 19A shows the manipulator assembly disposed in a third manipulator assembly position, the manipulator is shown disposed in a first input position, and portions of the manipulator assembly are shown in dashed lines; FIG. - FIG. 19B is another perspective view of a portion of the retainer and handle assembly of the end effector of FIG. 19B. 18 is a perspective view of the retainer of FIG. 17 showing the plunger positioned in a locked position to limit movement of the handle assembly relative to the rotating instrument between handle assembly positions; FIG. 20A is another perspective view of the retainer of FIG. 20A showing the plunger positioned in an unlocked position to allow movement of the handle assembly relative to the rotating instrument between handle assembly positions; FIG. FIG. 5 is a perspective view of the drive assembly of FIGS. 1-4 showing the manual interface and connector positioned along a second axis; FIG. 22 is a top view of the drive assembly of FIG. 21; FIG. The drive assembly includes a gear train that converts torque from the rotating equipment to the connector to rotate the tool, and a clutch mechanism interposed between the manual interface and the gear train, the clutch mechanism connecting the manual interface to the gear train. 22 is a cross-sectional view taken along line 23--23 of FIG. 22 shown operating in a first mode to cause rotation of the connector through torque from a rotating device without rotation; be. 23B shows the gear train, clutch mechanism, and connector of the drive assembly of FIG. 23A with the clutch mechanism operating in a second mode to cause rotation of the connector from a force applied to the manual interface; FIG. FIG. 3 is another cross-sectional view. FIG. 23B is an exploded perspective view of the drive assembly of FIGS. 21-23B. a fixture for supporting a rotating device to generate a torque about a first axis; a handle assembly disposed in a first handle assembly position; and a tool for rotating about a second axis. The surgical system of the present disclosure similarly configured for use with the surgical system of FIG. FIG. 3 is a perspective view of an end effector according to a second embodiment. The end effector of FIG. 25A showing the handle assembly positioned in the second handle assembly position and the protective cover positioned in the second protective position to facilitate access to the manual interface. FIG. 25A-25B is an exploded perspective view of the end effector of FIGS. 25A-25B showing the manipulator assembly spaced between the drive assembly and the rotating device; FIG. FIG. 27 is a cross-sectional perspective view of the manipulator assembly of FIGS. 25A-26 shown as a generally longitudinal cross-section showing the input manipulator positioned in a first input position; 27B is another cross-sectional perspective view of the controller assembly of FIG. 27A showing the input controller positioned in a second input position; FIG. FIG. 27 is a cross-sectional perspective view of the drive assembly of FIGS. 25A-26 shown as a generally longitudinal section. a drive assembly having a fixture for supporting a rotating instrument to generate torque about a first axis and a connector for supporting a tool for rotation about a second axis; and a first manipulator assembly. and a control assembly shown having first and second frame bodies disposed in position and having first and second frame bodies, the second frame body having a second frame body configured to restrict access to the manual interface. 2 is a perspective view of an end effector similarly configured for use with the surgical system of FIG. 1, according to a third embodiment of the present disclosure, shown disposed in one grip position; FIG. 29B is another perspective view of the end effector of FIG. 29A showing the second frame body positioned in a second grip position to facilitate access to the manual interface; FIG. the drive assembly is shown spaced apart from the rotary equipment and handle assembly, two tools are shown configured to be releasably attached to the drive assembly, one of the tools includes: 29A-29B is an exploded perspective view of the end effector of FIGS. 29A-29B shown as a rotary cutting tool with a drill bit, the other of the tools being shown as a rotary drive tool supporting a fixture; FIG. FIG. 12 is a view, shown as a generally longitudinal section, showing the transmission having a conversion collar disposed in a first collar position to engage a first gear set of the transmission; 30 is a cross-sectional perspective view of a portion of a drive assembly and rotary drive tool; FIG. the transmission having a conversion collar disposed in a second collar position to engage a second gear set of the transmission, a switching device having a portion of the rotary cutting tool operably attached to the conversion collar; 31 is a cross-sectional perspective view of a portion of the drive assembly and rotary cutting tool of FIG. 30 shown as a generally longitudinal cross-section shown positioned to engage a vessel; FIG. a drive assembly having a mounting for supporting a rotating equipment to generate torque about a first axis and a connector for supporting a tool for rotation about a second axis; a differential assembly; An end effector according to a fourth embodiment of the present disclosure similarly configured for use with the surgical system of FIG. 1 showing the end effector with a pair of pins and a handle assembly supported within a dock. FIG. the drive assembly is spaced apart from the rotary instrument, pin, and handle assembly, the two tools are configured to be releasably attached to the drive assembly, one of the tools 33 is an exploded perspective view of the end effector of FIG. 32 shown as a rotary cutting tool with a drill bit, the other of the tools being shown as a rotary drive tool supporting a fixture; FIG. 34 is a cross-sectional perspective view of the drive assembly of FIG. 33 shown as a generally longitudinal section showing the differential assembly in communication with first and second rotational stops of the drive assembly; FIG. A portion of the rotary cutting tool shown in FIG. 33 is shown positioned to engage a first rotary stop of the drive assembly for rotation about a second axis, and a portion of the rotary cutting tool shown in FIG. 34B is another cross-sectional perspective view of the drive assembly of FIG. 34A, one shown engaging a portion of the differential assembly; FIG. A portion of the rotational drive tool shown in FIG. 33 is shown positioned to engage a second rotational stop of the drive assembly for rotation about a second axis, and the portion of the rotational drive tool shown in FIG. 34A-34B is another cross-sectional perspective view of the drive assembly of FIGS. 34A-34B, the other shown engaging another portion of the differential assembly; FIG. 12 illustrates an end effector comprising a mount for supporting a rotating instrument to generate torque about a first axis and a drive assembly having a drive conduit for supporting a tool for rotation about a second axis. 2 is a perspective view of an end effector according to a fifth embodiment of the present disclosure similarly configured for use with the surgical system of FIG. 1, wherein the tool is shown as a drill bit rotary cutting tool; FIG. 36 is an exploded perspective view of the end effector of FIG. 35 showing the drive assembly spaced apart from the rotary equipment and the rotary cutting tool and from another tool shown as a rotary drive tool that drives the fixture; FIG. It is a diagram. A cross-sectional perspective view of the drive assembly of FIG. 36 shown as a generally longitudinal section showing a transmission having first and second gear sets arranged in rotational communication with the drive conduit. It is. 36 partially shown engaging a diverter secured within the drive conduit and operably attached to a conversion collar of the transmission, the conversion collar being engaged to a first gear set; FIG. 37B is another cross-sectional perspective view of the drive assembly of FIG. 37A shown positioned in a mating first collar position; 35-36 partially shown engaging a diverter secured within the drive conduit and operably attached to a conversion collar of the transmission, the conversion collar being a second gear. 37B is another cross-sectional perspective view of the drive assembly of FIG. 37A shown disposed in a second collar position to engage the set; FIG. FIG. 37B is a perspective view of the drive assembly of FIGS. 35-37C showing the transmission changeover positioned as shown in FIG. 37B; FIG. 37C is a perspective view of the drive assembly of FIGS. 35-37C showing the transmission changeover positioned as shown in FIG. 37C; a drive assembly having a mount for supporting a rotating instrument to generate torque about a first axis; a drive conduit for supporting a tool for rotation about a second axis; and a first manipulator. and a manipulator assembly shown disposed in an assembly position and having first and second frame bodies, the second frame body providing access to a manual interface defined by a tool. 2 is a perspective view of an end effector according to a sixth embodiment of the present disclosure similarly configured for use with the surgical system of FIG. 1, shown disposed in a first gripping position to limit the It is a diagram. 39B is another perspective view of the end effector of FIG. 39A showing the second frame body positioned in a second grip position to facilitate access to the manual interface defined by the tool; FIG. 39A-39B, the end of FIGS. 39A-39B showing the handle assembly disposed in the second handle assembly position and the second frame body shown disposed in the second gripping position. FIG. 3 is another perspective view of the effector. The manipulator assembly and the drive assembly are shown spaced apart from the rotating instrument, and the two tools are configured to be releasably attached to the drive conduit of the drive assembly, one of the tools being configured for surgical operation. shown as a rotary driven tool supporting a fixture as driven by a rotating instrument along a trajectory maintained by a robot, the other of the tools being guided along a trajectory maintained by a surgical robot 39A-39C is an exploded perspective view of the end effector of FIGS. 39A-39C shown as a dissection tool. FIG. FIG. 41 is a partial cross-sectional perspective view of the manipulator assembly of FIGS. 39A-40 shown as a generally longitudinal section; FIG. A light source is operably attached to a portion of the manipulator assembly, the manipulator assembly being positioned as shown in FIG. 39A, and the light source emitting light toward the surgical site along the second axis. FIG. 41 is a side view of the end effector of FIGS. 39A to 40 illustrating this. The tool includes a light source supported within the drive conduit of the drive assembly, the manipulator assembly is positioned as shown in FIG. 39B, and the light source emits light toward the surgical site along a second axis. FIG. 41 is a side view of the end effector of FIGS. 41 is a partially exploded cross-sectional perspective view of the drive assembly of FIGS. 39A-40 shown as a generally longitudinal section showing an axial catch for releasably securing the rotary drive tool of FIG. 40; FIG. 43B is a cross-sectional perspective view of the drive assembly of FIG. 43A showing the dissection tool of FIG. 40 positioned within the drive conduit; FIG. 43A-43B is a perspective cross-sectional view of the drive assembly of FIGS. 43A-43B showing the rotary drive tool of FIG. 40 secured to the drive conduit by an axial catch and a rotational catch; FIG. shown in section along a plane (not shown) arranged about a second axis and at an acute angle to a longitudinal plane (not shown) arranged about a first axis; 43C is another cross-sectional perspective view of the drive assembly, rotary drive tool, and rotary stop of FIG. 43C; FIG. FIGS. 43C-43C, shown in cross-section along a plane (not shown) disposed perpendicular to the second axis, with an axial stop shown disposed in a locking configuration. 43D is another cross-sectional perspective view of the drive assembly, rotary drive tool, and rotary stop of FIG. 43D; FIG. 44B is another cross-sectional perspective view of the drive assembly, rotary drive tool, and rotary stop of FIG. 44A showing the axial stop positioned in a released configuration; FIG. a drive assembly having a fixture for supporting a rotating instrument to generate torque about a first axis; a drive assembly having a drive conduit for supporting a tool for rotation about a second axis; and a manipulator assembly. 2 is a perspective view of an end effector similarly configured for use with the surgical system of FIG. 1, according to a seventh embodiment of the present disclosure, showing an end effector comprising: FIG. The drive assembly is shown spaced apart from the rotating instrument and manipulator assembly, and the two tools are configured to be releasably attached to the drive conduit of the drive assembly, one of the tools being configured for surgical operation. A rotating cutting tool is shown with a drill bit driven by a rotating instrument along a trajectory maintained by a robot, the other of the tools being shown as a scalpel tool guided along a trajectory maintained by a surgical robot. 46 is an exploded perspective view of the end effector of FIG. 45, shown in FIG. 46 is a cross-sectional perspective view of the drive assembly of FIGS. 45-46 shown as a generally longitudinal section showing that the drive conduit includes a collet mechanism having a collet tensioner disposed in a locking configuration; FIG. It is a diagram. 47A is another cross-sectional perspective view of the drive assembly of FIG. 47A showing the collet tensioner positioned in a released configuration; FIG. Another cross-sectional perspective view of the drive assembly of FIG. 47A showing the collet tensioner arranged in a locking configuration to secure a portion of the rotary cutting tool of FIG. 46 for rotation about a second axis. It is a diagram. FIG. 48 is a perspective view of the drive assembly of FIGS. 45-48 showing the collet tensioner positioned as shown in FIG. 47A; FIG. 48 is a perspective view of the drive assembly of FIGS. 45-48 showing the collet tensioner positioned as shown in FIG. 47B. A drive assembly having a fixture for supporting a rotating instrument to generate torque about a first axis and a drive conduit for supporting a tool for rotation about a second axis coincident with the first axis. and a manipulator assembly coupled to a drive assembly and a retention mechanism having a protective cover disposed in a first protective position, similarly for use with the surgical system of FIG. FIG. 7 is a perspective view of an end effector configured according to an eighth embodiment of the present disclosure. the protective cover is positioned in a second protective position and the end effector is positioned adjacent to two tools configured to be releasably attached to the drive assembly, one of the tools; 49A is another perspective view of the end effector of FIG. 49A, shown as a rotary cutting tool with a drill bit, the other of the tools being shown as a rotary drive tool supporting a fixture; FIG. 49A-49B is an exploded perspective view of the end effector of FIGS. 49A-49B showing portions of the retention mechanism and manipulator assembly spaced from the fixture and actuator subassembly; FIG. 51 is an exploded perspective view of a portion of the actuator subassembly of FIG. 50; FIG. 51 is an exploded perspective view of the manipulator assembly of FIG. 50 showing the first manipulator subassembly spaced apart from the second manipulator subassembly; FIG. 53 is an exploded perspective view of the second operating subassembly of FIG. 52; FIG. 53A is another exploded perspective view of the second operating subassembly of FIG. 53A; FIG. 53A-53B is a perspective partial cross-sectional view of the second operating subassembly of FIGS. 53A-53B shown as a generally longitudinal section; FIG. 53 is an exploded perspective view of the first operating subassembly of FIG. 52 showing a protective lock subassembly securing the retention mechanism of FIGS. 49A-50; FIG. 56 is a partial perspective view of the end effector of FIGS. 49A-50 showing the protective cover of the retention mechanism secured in a first protective position by the protective lock subassembly of FIG. 55; FIG. 56B is another partial perspective view of the end effector of FIG. 56A showing a portion of the retention mechanism engaged with a portion of the protective lock subassembly; FIG. 55 is a partial perspective view of the end effector of FIGS. 49A-50 showing the protective cover of the retention mechanism in a first protective position but disengaged from the protective lock subassembly of FIG. 55; FIG. It is. 56C is another partial perspective view of the end effector of FIG. 56C showing a portion of the retention mechanism disengaged from, but adjacent to, a portion of the protective lock subassembly; FIG. . 50 is a partial cross-sectional perspective view of the end effector of FIGS. 49A-50 shown as a generally longitudinal cross-section showing the protective cover of the retention mechanism disposed in a second protective position shown in FIG. 49B; FIG. be. 58 is an enlarged partial cross-sectional perspective view taken along mark 58 of FIG. 57. FIG. 58B is another enlarged partial cross-sectional perspective view of the end effector of FIG. 58A showing portions of the rotary drive tool of FIG. 49B supported within the drive conduit of the drive assembly; FIG. 58B is another enlarged partial cross-sectional perspective view of the end effector and rotary drive tool of FIG. 58B showing the protective cover of the retention mechanism positioned as shown in FIGS. 56C-56D; FIG. 58C is another enlarged partial cross-sectional perspective view of the end effector and rotary drive tool of FIG. 58C showing the protective cover of the retention mechanism positioned in the first protective position shown in FIGS. 56A-56B; FIG. 58 is an enlarged partial cross-sectional perspective view taken along mark 59 of FIG. 57. FIG. 59B is another enlarged partial cross-sectional perspective view of the end effector of FIG. 59A showing portions of the rotary drive tool of FIG. 49B supported within a drive conduit of a drive assembly; FIG. 49B is an exploded perspective view of the rotary drive tool and fixture of FIG. 49B showing the rotary drive tool having a locking subassembly; FIG. 61 is a partial cross-sectional perspective view of the rotary drive tool of FIG. 60 shown as a generally longitudinal cross-section showing the locking subassembly arranged in a power transmission lock configuration; FIG. 61B is another partial cross-sectional perspective view of the rotary drive tool of FIG. 61A showing the locking subassembly arranged in a power transfer unlocked configuration; FIG. is shown in cross section along a plane (not shown) disposed about the second axis and orthogonal to a longitudinal plane (not shown) also disposed about the second axis; 61 is a partial cross-sectional perspective view of the rotary drive tool of FIG. 60 showing the lock subassembly arranged in a power transmission lock configuration. 61B is another partial cross-sectional perspective view of the rotary drive tool of FIG. 61B showing the locking subassembly arranged in a power transfer unlocked configuration; FIG. a protective cover of the retention mechanism is disposed in a first protective position and adjacent the rotary drive tool of FIGS. 61A-62B, and a locking subassembly is disposed in a power transmission lock configuration to drive the fixture; FIG. 51 is a partial perspective view of the end effector of FIGS. 49A-50, showing the end effector of FIGS. The rotary drive tool of FIG. 63A is shown supported within the drive conduit of the drive assembly as shown in FIG. 58B, and the fixture is shown disposed along the track. FIG. 6 is another partial perspective view of the drive tool and fixture. 63B is another partial perspective view of the end effector, rotary drive tool, and fixture of FIG. 63B showing the protective cover of the retention mechanism positioned in the second protective position shown in FIG. 58D; FIG. the protective cover of the retention mechanism was positioned in a first protective position, the locking subassembly of the rotary drive tool was positioned in a power transmission lock configuration, and the fixture was shown to be advancing along the track; 63C is another partial perspective view of the end effector, rotary drive tool, and fixture of FIG. 63C; FIG. 63D is another partial perspective view of the end effector, rotary drive tool, and fixture of FIG. 63D showing the locking subassembly of the rotary drive tool arranged in a power transfer lock configuration; FIG. the rotary drive tool is removed from the end effector drive assembly and released from the fixture, the fixture being disposed along a track spaced from the end effector and the rotary drive tool; 63E is another partial perspective view of the end effector, rotary drive tool, and fixture of FIG. 63E; FIG.

In one or more of the embodiments illustrated throughout these drawings, certain components, structural features, and/or assemblies are omitted, shown schematically, and/or shown in dashed lines for illustrative purposes. That will be understood.

Referring now to the drawings, where like numerals indicate like or corresponding parts throughout the several views, a surgical system 30 comprising a surgical robot 32 is shown in FIG. Surgical robot 32 has a base 34, a robotic arm 36, and a coupler 38. As described in more detail below, a robotic arm 36 is supported by a base 34 and, during use, moves, guides, drives, maintains, or otherwise controls the position and/or orientation of a coupler 38 relative to the base 34. is configured to control the As described in more detail below, coupling 38 is adapted to releasably secure end effector 40 to a surgical site on patient's body B along one or more trajectories T. ST and is configured to drive a tool generally indicated at 42 . Accordingly, surgical robot 32 can be operated via robotic arm 36 to assist medical personnel in performing various types of surgical procedures with, among other things, precise control over the movement and positioning of end effector 40 and tool 42. Move the end effector 40.ロボットアーム３６の１つの例示的な配置が、開示が全体として参照により本明細書に組み込まれている、「Ｓｕｒｇｉｃａｌ Ｒｏｂｏｔｉｃ ａｒｍ Ｃａｐａｂｌｅ ｏｆ Ｃｏｎｔｒｏｌｌｉｎｇ ａ Ｓｕｒｇｉｃａｌ Ｉｎｓｔｒｕｍｅｎｔ ｉｎ Ｍｕｌｔｉｐｌｅ Ｍｏｄｅｓ」、という名称の米国特許第９， No. 119,655. It will be appreciated that the robotic arm 36 and other portions of the surgical robot 32 may be arranged in alternative configurations.

Surgical system 30 allows a user (e.g., a surgeon) to perform one or more types of surgery along a trajectory T maintained by surgical robot 32, at and/or for surgical site ST. The tool 42 is configured to assist in guiding, positioning, and/or positioning the tool 42 of the tool 42 . As will be appreciated from the following description of various embodiments of the present disclosure, the tool 42 allows, among other things, a high level of control over the trajectory T maintained by the surgical robot 32 to allow the surgeon to move the patient at the surgical site ST. can be supported by an end effector 40 to allow access and manipulation of the anatomy of body B. Each of the components of surgical system 30 introduced above will be described in more detail below.

Those skilled in the art will appreciate that conventional surgical procedures routinely involve the use of multiple different types of tools 42. Here, certain types of tools 42 can be characterized as "active" when configured to be driven by end effector 40 while supported along trajectory T (e.g., but not limited to rotary cutting equipment such as drills and burs). On the other hand, certain types of tools 42 are characterized as "passive" when they are configured to be guided (but not necessarily driven) by end effector 40 while being at least partially supported along trajectory T. (e.g., but not limited to, dissecting instruments and scalpels). Additionally, as will be appreciated from the discussion below, some types of tools 42 can be characterized as both "active" and "passive" depending on how they are used. can.

Although multiple different types of "active" tools 42 are contemplated by this disclosure, herein a rotary cutting tool 44 (e.g., having a drill bit) that forms a pilot hole 46 at the surgical site ST along the trajectory T is used. a rotary cutting instrument) and a rotary drive tool 48 (e.g. Two exemplary "active" tools 42 are described in connection with FIGS. 4-5F.

The exemplary embodiments of the end effector 40 and tools 42 described herein, shown in connection with the first embodiment of the end effector 40, generally extend to the posterior path vertebrae of two or more vertebrae of a patient's body B. It is configured to assist surgeons in performing various types of minimally invasive spinal surgery procedures, such as interbody spinal fusions. However, as will be appreciated from the discussion below, the surgical system 30 may be operated by an "active" tool 42 driven by an end effector 40 and/or a "passive" tool 42 guided by an end effector 40, etc. It may be used in connection with a number of different types of surgical procedures where it is advantageous to limit movement of tool 42 to rotation about axial trajectory T and translation along axial trajectory T. Here, the term "driven" generally corresponds to rotation of the tool 42 about the trajectory T. However, the tool 42 supported by an end effector 40 guided by the surgical robot 32 is only limited to the trajectory T and/or around the surgical site ST and/or relative to the trajectory T and/or the surgical site ST. It will be appreciated that it can be driven in a number of different ways, including, but not limited to, vibration, reciprocation, translation, rotation, or combinations thereof.

As mentioned above, the illustrated surgical system 30 may be advantageously utilized in connection with minimally invasive spinal surgical procedures, such as posterior pathway interbody spinal fusion. In this illustrative example, a rotary cutting tool 44 may be used to form a pilot hole 46 in different vertebrae, and a rotary drive tool 48 may be used to respectively attach a fixator 50 realized as a pedicle screw. can be used for installation into the pilot hole 46 of. A stabilizing rod (not shown) is then installed between the fixators 50 placed within the pedicles of two or more vertebrae of the patient's body B to limit the relative movement between these vertebrae and to can promote bone growth and help fuse the vertebrae together. It will be appreciated that the above examples are illustrative and that other types of surgical procedures are also contemplated.

In addition to forming the pilot hole 46 for the polyaxial pedicle screw fixator 50, in some embodiments the rotary cutting tool 44 also includes other types of fixation hardware (e.g., pins, screws, forming holes for prosthetic components (e.g., prosthetic joints, bone cages, implants, etc.), and/or medical devices (e.g., guidewires, instrumentation, sensors, trackers, etc.); Can be done. Additionally, in some embodiments, the rotary cutting tool 44 also cuts away from vertebrae and/or adjacent tissue (e.g., as a bar utilized during a laminectomy or discectomy) or other bones (e.g., from the iliac crest). (to facilitate grafting of the harvested bone). Thus, the tool 42 can be implemented as a number of different types of surgical tools for cutting, removing, manipulating, or treating tissue at a surgical site, and the end effector 40 directs the movement of the tool 42 toward the surgical site. It can be utilized in any suitable type of surgical procedure where it is advantageous to be limited to rotations about and translations along a trajectory T maintained by the robot 32. As mentioned above, other configurations are also contemplated.

Surgical system 30 may include various types of trackers (e.g., optical, inertial, and/or ultrasound sensing devices with multiple degrees of freedom), navigation systems (e.g., machine vision systems, charge-coupled device cameras, tracker sensors, surface scanners, and/or range finders), anatomical computer models (e.g., magnetic resonance imaging scans of the lower lumbar region of the spine), data from previous surgical procedures and/or previously performed surgical techniques (e.g., fusion surgical robot 32 in a common coordinate system, such as by utilizing data recorded by surgical robot 32 while forming a pilot hole 46 that is then used to facilitate placement of instrument 50; monitoring, tracking, and/or determining changes in the relative position and/or orientation of one or more portions of the robotic arm 36, end effector 40, and/or tool 42, and various portions of the patient's body B; It is possible to do this. To these ends, as shown schematically in FIG. 1, surgical system 30 generally cooperates to enable surgical robot 32 to maintain alignment of tool 42 along trajectory T. A control system 52 and a navigation system 54 are provided. Control system 52 includes an arm controller 56 and navigation system 54 includes a navigation controller 58. Controllers 56, 58 may be implemented as computers, processors, control units, etc., and may be separate components, integrated, and/or otherwise share hardware. Can be done.

Surgical system 30 employs control system 52 to facilitate articulation of robotic arm 36, drive of tool 42, etc., among other things. Here, arm controller 56 of control system 52 is configured to articulate robot arm 36 by driving various actuators, motors, etc. located at joints of robot arm 36 (not shown). Ru. Arm controller 56 also collects sensor data from various sensors (not shown), such as encoders, located along robot arm 36. Because the unique geometries of each component of the surgical robot, end effector 40, and tool 42 are known, the arm controller 56 uses these sensor data to align the components within the manipulator coordinate system MNPL (see FIG. 1). The position and/or orientation of the tool 42 can be reliably adjusted. Manipulator coordinate system MNPL has an origin, which is located relative to robot arm 36. An example of this type of manipulator coordinate system MNPL is found in U.S. Pat. listed.

Surgical system 30 uses navigation system 54 to track the movement of various objects, such as tools 42 and portions of patient's body B (eg, vertebrae located at surgical site ST), among others. To this end, the navigation system 54 comprises a localizer 60 configured to sense the position and/or orientation of a tracker 62 fixed to an object in the localizer coordinate system LCLZ. Navigation controller 58 is arranged to communicate with localizer 60 and collects position and/or orientation data for each tracker 62 sensed by localizer 60 within localizer coordinate system LCLZ.

It will be appreciated that the localizer 60 can sense the position and/or orientation of multiple trackers 62 and correspondingly track multiple objects in the localizer coordinate system LCLZ. By way of example, as shown in FIG. 1, trackers 62 may include pointer tracker 62P, tool tracker 62T, first patient tracker 62A, and/or second patient tracker 62B, as well as additional patient trackers, additional medical and and/or trackers for surgical tools. In FIG. 1, a tool tracker 62T is rigidly secured to the end effector 40, a first patient tracker 62A is rigidly secured to one vertebra (e.g., S1 of the sacrum) at the surgical site ST, and a first patient tracker 62T is rigidly secured to one vertebra (e.g., S1 of the sacrum) at the surgical site ST. Tracker 62B is firmly fixed to a different vertebra (eg, L5 of the lumbar vertebra). Tool tracker 62T can also be secured to end effector 40 in different ways, such as by being integrated into or releasably attached to end effector 40 during manufacturing. Patient trackers 62A, 62B are securely secured to different bones of patient's body B, such as by threaded engagement, tightening, or other techniques. It will be appreciated that the various trackers 62 can be secured to different types of tracked objects (eg, individual bones, tools, pointers, etc.) in a number of different ways.

The position of the tracker 62 relative to the anatomical structure to which it is attached can be determined by known registration techniques such as point-based registration, on bone landmarks on the bone, or on surface-based positions. In the case of alignment, a pointer tracker 62P (eg, a navigation pointer) is used to delineate several points across the bone. Conventional alignment techniques can be used to correlate the pose of tracker 62 to the patient's anatomy (eg, each respective vertebra). Other types of alignment are also possible, such as by using a tracker 62 that has a mechanical clamp attached to the spinous process of the vertebrae, such mechanical clamp determining the shape of the spinous process to which the clamp is attached. It has a tactile sensor (not shown) for The shape of the spinous process can then be matched to the 3D model of the spinous process for alignment. A known relationship between the tactile sensor and the three or more markers on tracker 62 may be input to or otherwise known by navigation controller 58 . Based on this known relationship, the position of the marker relative to the patient's anatomy can be determined.

Collecting, determining, or otherwise manipulating position and/or orientation data by a navigation controller 58 that determines the coordinates of each tracker 62 within the localizer coordinate system LCLZ using conventional alignment/navigation techniques. Can be done. These coordinates are communicated to control system 52 to facilitate articulation of robotic arm 36, as described in more detail below.

In the exemplary embodiment shown in FIG. 1, the arm controller 56 is operably attached to the surgical robot 32, and the navigation controller 58 and localizer 60 are both moveable relative to the base 34 of the surgical robot 32. It is supported on a cart 64. Mobile cart 64 is also shown generally at 66 for facilitating operation of surgical system 30 by displaying information to and/or receiving information from the surgeon or other user. Support user interface. User interface 66 is arranged to communicate with navigation system 54 and/or control system 52 to present information (e.g., images, video, data, graphics, navigable menus, etc.) to the surgeon. one or more output devices 68 (e.g., monitors, indicators, display screens, etc.) and one or more input devices 70 (e.g., buttons, touch screens, keyboards, mice, gesture- or voice-based input devices, etc.). ). One type of mobile cart 64 and user interface 66 is described in US Pat. No. 7,725,162 entitled "Surgery System," which is incorporated herein by reference in its entirety.

Because the moving cart 64 and base 34 of the surgical robot 32 can be positioned relative to each other and relative to the patient's body B, the surgical system 30 determines the coordinates of each tracker 62 from the localizer coordinate system LCLZ. the relative position and Based on the orientation, articulation of the robot arm 36 can be performed. It will be appreciated that a number of different conventional coordinate system transformation techniques can be used to transform coordinates in the localizer coordinate system LCLZ to coordinates in the manipulator coordinate system MNPL, and vice versa.

In the illustrated embodiment, localizer 60 is an optical localizer and includes a camera unit 72 with one or more optical position sensors 74 . Navigation system 54 uses optical position sensor 74 of camera unit 72 to sense the position and/or orientation of tracker 62 within localizer coordinate system LCLZ. In the exemplary embodiment shown herein, trackers 62 each employ active markers 76 (eg, light emitting diodes "LEDs") that emit light that is sensed by optical position sensor 74 of camera unit 72. An example of this type of navigation system 54 is described in U.S. Pat. No. 9,008,757 entitled "Navigation System Including Optical and Non-Optical Sensors," the disclosure of which is incorporated herein by reference in its entirety. has been done. In other embodiments, tracker 62 can include passive markers, such as reflectors that reflect light emitted from camera unit 72. It should be understood that other suitable tracking systems and methods not specifically described herein (eg, ultrasound, electromagnetic, radio frequency, etc.) may also be utilized.

In some embodiments, the surgical system 30 provides an image of the tracked object, such as presenting an image and/or graphical representation of the vertebrae and the tool 42 on one or more output devices 68 (e.g., a display screen). A virtual representation of relative position and orientation may be displayed to the surgeon or other user of surgical system 30. Arm controller 56 and/or navigation controller 58 also utilize a user interface 66 to allow a surgeon or other user to interact with control system 52 to facilitate articulation of robotic arm 36. , instructions or request information can be displayed. Other configurations are also contemplated.

It will be appreciated that control system 52 and navigation system 54 may also cooperate to facilitate control of the position and/or orientation of tool 42 in different ways. By way of example, in some embodiments, the arm controller 56 is configured to control the robotic arm 36 (e.g., by driving joint motors) to provide tactile feedback to the surgeon via the robotic arm 36. ). Here, haptic feedback helps constrain or restrain the surgeon from manually moving the end effector 40 and/or tool 42 beyond predefined virtual boundaries associated with the surgical procedure (e.g., to maintain alignment of the tool 42 along the line). One type of haptic feedback system and associated haptic objects that define virtual boundaries are disclosed, for example, in US Pat. No. 8, entitled "Haptic Guidance System and Method," the disclosure of which is incorporated herein by reference in its entirety. , No. 010,180. In one embodiment, surgical system 30 is manufactured by MAKO Surgical Corp. of Fort Lauderdale, Florida, USA. RIO™ Robotic Arm Interactive Orthopedic System manufactured by RIO™ Robotic Arm Interactive Orthopedic System.

Referring now to FIGS. 1-11F, as discussed above, surgical system 30 performs various types of surgical procedures through precise control of the relative position and orientation of tool 42 with respect to patient's body B. To assist the surgeon, the end effector 40 is used to drive the tool 42 at the surgical site ST along different trajectories T maintained by the surgical robot 32.

As best shown in FIGS. 3-4, the end effector 40 generally includes a fixture 78 adapted to be attached to and move simultaneously with the coupling 38 of the robotic arm 36 of the surgical robot 32 (see FIGS. (see 1). A rotating device, indicated generally at 80, is coupled to the fixture 78 and is configured to selectively generate rotational torque about a first axis A1, as described in more detail below. A drive assembly 82 includes a gear train 84 that converts rotation about a first axis A1 from the rotating device 80 into rotation about a second axis A2 that is different from the first axis A1. In the exemplary embodiment shown in connection with the first embodiment of end effector 40, second axis A2 intersects first axis A1 and is substantially perpendicular to first axis A1. However, it will be appreciated that other arrangements of the axes A1, A2 are also contemplated. Drive assembly 82 also includes a connector, shown generally at 86, that is configured to releasably secure a different type of tool 42 for rotation about second axis A2. A manipulator assembly, shown generally at 88, includes a grip 90 for supporting a user's hand (eg, a surgeon's hand) and an input manipulator 92 that interfaces with rotating instrument 80. The input manipulator 92 is arranged to, when selectively engaged by a user, drive the rotary instrument 80 to rotate the tool 42 about the second axis A2 at different rotational speeds. End effector 40 also includes a manual interface, shown generally at 94, that cooperates with drive assembly 82 to receive applied force from a user and rotate tool 42 about second axis A2. Convert it to rotational torque for rotation. To this end, in the illustrated embodiment, a manual handle assembly 96 is provided for releasably attaching to manual interface 94, as shown in FIGS. 3, 4, 10B, and 11B-11C. Manual interface 94 and handle assembly 96 allow manual operation (e.g., manual drilling, screw drive, etc.) and power-driven operation (e.g., power-driven drilling, screw drive, etc.) via torque from rotating equipment 80. It gives the surgeon the ability to perform a combination of Thus, depending on the particular procedure being performed, the type of tool 42 utilized in that procedure, the surgeon's preferences, etc., certain steps of the surgical procedure may be powered via rotating instrument 80. , other steps can be performed manually via the handle assembly 96. Each of the components of end effector 40 and components for use with end effector 40 introduced above are described in more detail below.

Minimally invasive spinal fixation techniques (as well as other types of surgical procedures) generally involve placing multiple fixators 50 within two or more vertebrae at the surgical site ST. For example, in a posterior pathway lumbar interbody fusion of two adjacent vertebrae (e.g., fusion of S1 of the sacrum to L5 of the lumbar vertebrae), typically the pedicles on either side of the spinous process of each vertebra to be fused are Fixtures 50 are installed inside to the left and right, and correspondingly support the left and right stabilizing rods. Therefore, fixating two adjacent vertebrae generally involves installing at least four fixators 50, and each additional vertebra to be fixed generally involves installing two more left and right fixators 50. (For example, a combination of sacral S1 fixation for lumbar L5 and lumbar L5 fixation for lumbar L4). Furthermore, a fixator 50 is carefully placed in the vertebrae relative to the spinal cord, nerve roots, etc., such as to extend from the adjacent lamina into the vertebral body and across each pedicle without passing through the vertebral foramen. Those skilled in the art will understand what must be done. Therefore, each fixture 50 is installed along a different trajectory T, as shown in FIGS. 2A-2C.

5A-5G each illustrate a vertebra (e.g., L5 of the lumbar vertebrae) in a transverse direction to facilitate installation of a fixator 50 via a rotating instrument 80 and, in some embodiments, a manual interface 94. The following sequentially shows how the tool 42 supported by the end effector 40 can be utilized. In FIG. 5A, a first trajectory T1 and a second trajectory T2 are shown to be placed bilaterally with respect to the spinous process, each extending to the vertebral foramen and the respective pedicle on each side of the spinal cord. and extends into the vertebral body. One fixture 50 is shown already installed along the first trajectory T1, with the distal cutting end 44D of the rotary cutting tool 44 (e.g., the tip of a drill bit) positioned at the surgical site ST. It is shown that it is adjacent to Here, the rotary cutting tool 44 is supported for rotation about a second axis A2, and the surgical robot 32 maintains alignment of the second axis A2 with respect to the second trajectory T2.

FIG. 5B shows the rotary cutting tool 44 advanced along a second trajectory T2 through the pedicle to position the distal cutting end 44D at a first depth D1 into the vertebrae at the surgical site ST. 5C shows the rotary cutting tool 44 further advanced along the second trajectory T2 to position the distal cutting end 44D at a second depth D2 that is greater than the first depth D1.

FIG. 5D shows a pilot hole 46 formed by the rotary cutting tool 44 extending along a second trajectory T2 into the vertebra to a second depth D2. FIG. 5D also shows the distal tip 50D of another fixture 50 positioned adjacent the surgical site ST to be installed within the pilot hole 46. Here, the fixture 50 is supported by the rotary drive tool 48 to rotate around the second axis A2 (see FIGS. 3-4), and the surgical robot 32 similarly rotates around the second trajectory T2. Maintaining the alignment of the second axis A2.

FIG. 5E shows the fixture 50 advanced along the second trajectory T2 after being "threaded" into the pilot hole 46 via rotation of the rotary drive tool 48 about the second axis A2. In this FIG. 5E, the distal tip 50D of the fixator 50 is positioned at a third depth D3 into the vertebrae, in this example the third depth D3 is greater than the second depth D2, but the third depth D3 is greater than the second depth D2; It can also be the same as or smaller than the second depth D2.

In FIG. 5F, the fixture 50 is shown further advanced along the second trajectory T2 to position the distal tip 50D at a fourth depth D4 that is greater than the third depth D3. There is. Here, the fourth depth D4 represents the intended final position FP of the installed fixtures 50, and the final positions FP of both left and right fixtures are shown in FIG. 5G, with each fixture 50 are aligned with the respective trajectories T1, T2.

With continued reference to FIGS. 5A-5G, it will be appreciated that the surgeon can advance the rotary cutting tool 44 or the rotary drive tool 48 along the second trajectory T2 in a number of different ways. Because of how the illustrated rotary cutting tool 44 and rotary drive tool 48 are configured, rotation of the tool 42 about the second axis A2 may cause the distal cutting end 44D to rotate in response to engagement with bone. and/or tend to advance the distal tip 50D along a second trajectory T2. Despite this tendency, surgeons generally operate surgical robot 32 in a manner that inhibits movements or articulations of robot arm 36 that would otherwise disalign second axis A2 with respect to second trajectory T2. While operating in the tactile mode, tool 42 is advanced along second trajectory T2 by applying a force to grip 90 of manipulator assembly 88.

In some embodiments, surgical system 30 is configured to operate differently upon approaching or reaching one or more of depths D1, D2, D3, D4. For example, surgical system 30 allows a surgeon to engage input manipulator 92 to drive rotary instrument 80 to rotate rotary cutting tool 44 about second axis A2 until first depth D1 is reached. It can be configured to allow rotation (see Figure 5B). After reaching the first depth D1, the surgical system 30 ceases rotation and, inter alia, the surgeon, via engagement of the handle assembly 96 to the manual interface 94, moves from the first depth D1 to the second depth D1. Manual advancement (eg, without torque from rotating equipment 80) to depth D2 (see FIG. 5C) may be enabled.

The surgical system 30 similarly ceases rotation when the fixture 50 is installed, such as when the distal tip 50D reaches the third depth D3 (see FIG. 5E), so the surgeon can Installation from the third depth D3 to the fourth depth D4 (see FIG. 5F) can be completed manually through engagement of the handle assembly 96 to the manual interface 94. In addition to ceasing rotation at a predetermined depth, surgical system 30 may also slow rotation as a certain depth is approached, limit translation speed along second trajectory T2, or otherwise Variable control over the rotation and/or translation of the tool 42 can be provided in this manner.

The installation sequence shown in FIGS. 5A-5G is intended to be illustrative and non-limiting, and depths D1, D2, D3, D4 are representative of how tool 42 may be utilized. Although it is intended to be an arbitrary reference point to help describe the can. Additionally, the above discussion of depths D1, D2, D3, D4 in connection with FIGS. 5A-5G generally refers to the rotation of tool 42 by rotating equipment 80 until one depth (e.g., D1 or D3) is reached. and rotation of tool 42 by manual interface 94 to a final depth (e.g., D2 or D4); however, in some embodiments, rotation of tool 42 to a final depth (e.g., D2 or D4) It is contemplated that rotation equipment 80 or manual interface 94 may be utilized alone to rotate up to . As an illustrative example, rotary equipment 80 may be used to drive rotary cutting tool 44 to form a pilot hole to a second depth D2 (from first depth D1 to second depth D2), at which point the surgical system 30 may cease rotating the rotating instrument 80 and prompt the surgeon to switch to the rotary drive tool 48 and place the fixture 50. can. Rotary drive tool 48 may then be manually rotated to fourth depth D4 via manual interface 94 without the use of torque from rotating equipment 80. In other words, the specific It is contemplated that tool 42 can be rotated. Other configurations are also contemplated.

It is understood that the workflow associated with installing fixture 50 may differ from the exemplary embodiments described herein based on the specific surgical procedure being performed, the configuration of fixture 50, etc., among other things. Good morning. As a non-limiting example, instead of forming a pilot hole 46 to help facilitate installation of the fixture 50 shown throughout the figures, the fixture 50 may include a pre-formed pilot hole 46. to facilitate a "single pass" workflow that does not necessarily require the formation of pilot holes 46, such as fixtures 50 that are "self-tapping" or otherwise configured to be installed without the need for It is contemplated that the configuration can be configured. Other configurations are also contemplated.

6-9, rotary drive tool 48 and fixture 50 are shown in more detail. As mentioned above, the illustrated fixator 50 is implemented as a pedicle screw implant configured to be placed into a vertebra using a minimally invasive surgical technique and has a threaded body 98 supported by a polyaxial head 100. A blade 102 is removably fixed to the multi-axis head 100. An exemplary embodiment of the construction of this type of fixture 50 is disclosed in U.S. Pat. , No. 716. In some embodiments, the surgical system 30 is manufactured by U.S. Pat. and/or may facilitate the installation of this or other types of fixtures 50 as described in US Patent Application Publication No. 2018/0042650 (A1) entitled "Power Pedicle Screwdriver." It will be appreciated that other types and configurations of fixtures 50 and their associated installations are also contemplated by this disclosure.

As best shown in FIG. 9, rotary drive tool 48 generally includes a drive shaft 104 rotatably supported within support tube 106. As best shown in FIG. A contoured body 108 is coupled to the support tube 106 for simultaneous rotation and configured to facilitate, among other things, mounting the rotary drive tool 48 to the fixture 50 when engaged by the surgeon. be done. Contour body 108 selectively engages lock subassembly 110 for simultaneous rotation via a spline engagement, generally indicated at 112.

Lock subassembly 110 is configured to selectively limit axial movement of drive shaft 104 relative to support tube 106. To this end, lock subassembly 110 includes a locking body 114 that supports a slider 116 for movement transversely to drive shaft 104 . In the illustrated embodiment, the slider 116 is biased by a spring 118 and held against the locking body 114 via a pin 119. The support tube 106 includes external threads 120 that engage corresponding internal threads 122 formed in the vanes 102 of the fixture 50 , and the distal end of the drive shaft 104 includes a drive key 124 . engages a correspondingly shaped follower key 126 formed within the proximal end of the threaded body 98 of the fixture 50 and adjacent the multi-axis head 100 . Accordingly, the rotary drive tool 48 is releasably attachable to the fixture 50 through the engagement between the drive key 124 and the driven key 126 and between the external threads 120 and internal threads 122. One exemplary embodiment of this type of rotary drive tool 48 and fixture 50 is disclosed in the United States patent entitled "System and Method for Spinal Implant Placement," the disclosure of which is incorporated herein by reference in its entirety. No. 8,002,798.

A bit interface, shown generally at 128, is coupled to the proximal end of drive shaft 104 adjacent lock subassembly 110. Bit interface 128 is configured to be releasably attached to connector 86 of drive assembly 82 of end effector 40 to limit translation and rotation of rotary drive tool 48 relative to connector 86, respectively, as described in more detail below. An axial retainer 130 and a rotary retainer 132 are provided which engage the connector 86 in a similar manner. As best shown in FIG. 8, the threaded body 98 of the fixture 50 and the drive shaft 104 and bit interface 128 of the rotary drive tool 48 may be penetrated by, among other things, a guide wire GW (e.g., a "K-wire"). A cannula is inserted to allow this (not shown in detail).

1-24, as described above, the surgical robot 32 maintains the alignment of the second axis A2 with respect to the trajectory T and the force applied by the surgeon to the grip 90 of the manipulator assembly 88. etc., the end effector 40, via torque from the rotary instrument 80 or the manual interface 94, allows the end effector 40 and the tool 42 to translate simultaneously along the second axis A2. The tool 42 is configured to facilitate rotation of the tool 42 about the second axis A2. As best shown in FIGS. 10A-12, the fixture 78 supports various other components of the end effector 40 and is advantageously attached to the coupling 38 (see FIG. 1) of the robot arm 36. 2 and is configured to promote, among other things, hardness and stiffness of the end effector 40 while providing advantages in terms of usability, stability, and precision of the surgical system 30.

In the exemplary embodiment of the manipulator assembly 88 shown in connection with the first embodiment of the end effector 40, the grip 90 has a generally cylindrical shape to generally pronate or supinate engagement of the hand. configured to do so. Thus, when the surgeon is actuating the manipulator assembly 88 to produce torque by the rotating instrument 80, the surgeon's hand is positioned such that the second axis A2 extends generally through the grip 90 (FIGS. 10A and 11A) is positioned above the drive assembly 82. This advantageously allows the surgeon's hand to be positioned along the trajectory T while engaging the manipulator assembly 88, thereby providing a direction in which the surgeon is substantially aligned with the trajectory T. A force can be applied to end effector 40 to help advance tool 42. Additionally, this configuration allows the surgeon to engage grip 90 without substantially obstructing the surgeon's view of drive assembly 82, tool 42, or surgical site ST. However, manipulator assembly 88 and/or grip 90 may be configured in other ways, such as where grip 90 is shaped and positioned for generally neutral (as opposed to pronated or supinated) hand engagement. It will be appreciated that the rotary device 80 can be positioned in line with or offset from the trajectory T when engaged to drive the rotating equipment 80. Other configurations are also contemplated.

The above-described embodiment of the manipulator assembly 88 shown throughout the figures advantageously allows the surgeon to It will be appreciated that while the hand is positioned along the trajectory T, necessarily in this configuration the grip 90 is positioned to at least partially inhibit access to the manual interface 94. To facilitate access to manual interface 94 , handle assembly 88 includes a frame, shown generally at 134 , that allows grip 90 and input handle 92 to drive rotary instrument 80 to rotate tool 42 . A first manipulator assembly position P1 arranged to be engaged by a surgeon for rotation about a second axis A2 (see FIGS. 10A, 11D, 11E, and 19A-19B) , and grip 90 and input control 92 are positioned to facilitate access to manual interface 94 such that manual interface 94 receives applied force from a user to direct tool 42 in the second axis. for movement relative to rotating instrument 80 between a plurality of manipulator assembly positions, including a second manipulator assembly position P2 (see FIGS. 10B and 11B-11C) arranged for rotation about A2; It supports a grip 90 and an input operating tool 92. Other manipulator assembly locations are also contemplated, as described in more detail below.

As best shown in FIGS. 15, 17, and 19A-19C, the handle assembly 88 includes a retainer, generally designated 136, which is movable to the frame 134 for simultaneous movement. is combined with In the illustrated embodiment, retainer 136 is formed as a separate component from frame 134 to facilitate assembly of end effector 40, but in other embodiments retainer 136 is integrally formed with frame 134. You can also do that.

Retainer 136 is configured to prevent inadvertent movement of grip 90 of manipulator assembly 88 relative to rotating equipment 80 . To this end, retainer 136 includes a plunger 138 that is selectively movable between a locked position 138L (see FIG. 20A, see also FIG. 15) and an unlocked position 138U (see FIG. 20B). A catch, indicated generally at 140, is operably attached (e.g., via a fastener) to rotary equipment 80 and has a plurality of receptacles 141, each of which engages plunger 138 of retainer 136. It is shaped to be received at locking position 138L to define one of manipulator assembly positions P1, P2. As best shown in FIGS. 19A-19C, the catch 140 has a generally annular shape and the receiving portions 141 each have a generally cylindrical shape and are radially spaced apart from each other about the catch 140. be placed. It will be appreciated that the placement of retainer 136 and catch 140 may be interchanged so that the plunger remains stationary relative to rotary instrument 80 rather than moving simultaneously with handle assembly 88.

15 and 20A-20B, retainer 136 includes a release lever 142 that cooperates with plunger 138. Referring now to FIGS. Release lever 142 is arranged to facilitate movement of plunger 138 between a locked position 138L (see FIG. 20A) and an unlocked position (see FIG. 20B) when engaged by a surgeon or another user. be done. The plunger 138 is supported for movement along a plunger hole 144 formed within the retainer 136 and is coupled to a release lever 142 via a lever guide pin 146 , the lever guide pin 146 being coupled within the retainer 136 . The retainer slot 148 (shown in phantom in FIGS. 20A-20B) is supported for translation along a retainer slot 148 (shown in phantom in FIGS. 20A-20B). A plunger biasing element 150 (see FIG. 15), such as a compression spring, is interposed between plunger 138 and retainer 136 to move plunger 138 to locked position 138L. To move the plunger 138 to the unlocked position 138U, the release lever 142 supports a clasp element 152 that is selectively inserted into a correspondingly shaped clasp pocket 154 formed in the retainer 136. Can be positioned. Clasp element 152 is attached to release lever 142 via clasp pin 156.

To move plunger 138 to unlocked position 138U, the surgeon or another user applies a force to release lever 142 generally away from catch 140 until clasp element 152 enters clasp pocket 154 to guide the lever. Plunger biasing element 150 may be compressed as pin 146 translates along retainer slot 148. The corresponding shapes of clasp element 152 and clasp pocket 154 maintain plunger 138 in unlocked position 138U, and the surgeon or another user can then apply a force to release lever 142 in a direction generally toward catch 140. , the clasp element 152 is removed from the clasp pocket 154, whereby the energy stored within the plunger biasing element 150 returns the plunger 138 to the locked position 138L. It will be appreciated that other configurations of retainer 136, plunger 138, and catch 140 are also contemplated.

As shown in FIG. 17, rotary device 80 includes a journal, generally indicated at 158, and manipulator assembly 88 includes a bearing surface 160 operably attached to frame 134, bearing surface 160 engages journal 158. so that the manipulator assembly 88 is positioned around the manipulating axis A3 (see FIGS. 19A-19C) at the manipulator assembly position P1 (see FIGS. 10A, 11A, and 19A-19B), It is selectively movable with respect to the rotating device 80 between P2 (see FIG. 10B and FIGS. 11B to 11C) and P3 (see FIG. 11F and FIG. 19C). In other words, in the illustrated embodiment, frame 134 supports manipulator assembly 88 for rotation relative to rotary instrument 80 between manipulator assembly positions P1, P2, and P3. As shown in FIG. 17, bearing surface 160 is defined by a cap element 162 attached to frame 134 via fasteners, as well as a portion of frame 134 adjacent cap element 162. at other locations along the rotating device 80 and the manipulator assembly 88 (e.g., adjacent to the retainer 136) to promote smooth rotational movement between the rotating device 80 and the manipulator assembly 88, respectively. Other journals and bearing surfaces can also be provided. Although the embodiments described above are directed to rotational movement of the handle assembly 88 between the first handle assembly position P1 and the second handle assembly position P2, other types of movement are also contemplated. will be understood. As an illustrative example, some embodiments may utilize pivoting, sliding, translation, and/or combinations thereof.

As mentioned above, in the illustrated embodiment, the grip 90 of the manipulator assembly 88 supports the surgeon's hand along the trajectory T as the surgeon engages the input manipulator 92 to drive the rotary instrument 80. Place it like this. In one embodiment, the second axis A2 intersects at least a portion of the handle assembly 88 at the first handle assembly position P1 (see FIG. 10A). Further, as shown in FIG. 11A, when the manipulator assembly 88 is in the first manipulator assembly position P1, the grip 90 is substantially orthogonal to the second axis A2. Conversely, as shown in FIG. 11B, when the manipulator assembly 88 is in the second manipulator assembly position P2, the grip 90 is substantially parallel to the second axis A2. (shift). Accordingly, in the illustrated embodiment, movement from the first handle assembly position P1 to the second handle assembly position P2 includes rotating the handle assembly 88 approximately 90 degrees relative to the rotating instrument 80. Accordingly, as shown in FIGS. 19A-19C, the receiving portions 141 of the catch 140 defining the first manipulator assembly position P1 and the second manipulator assembly position P2 are 90 degrees from each other with respect to the manipulating axis A3. placed apart. Additionally, other handle assembly positions are defined, such as a third handle assembly position P3 (see FIGS. 11F and 19C) between the first handle assembly position P1 and the second handle assembly position P2. For this purpose, an additional receiving portion 141 is provided. It will be appreciated that any suitable number of receptacles 141 may be provided to define a corresponding number of individual manipulator assembly positions spaced from each other in a plurality of different ways.

As shown schematically in FIG. 16, in one embodiment, the end effector 40 includes an assembly sensor arrangement, indicated generally at 164, that is arranged between the handle assembly positions P1, P2, P3. interposed between the rotating device 80 and the manipulator assembly 88 to determine the position of the manipulator assembly 88 relative to the rotating device 80 (see FIGS. 11A, 11B, and 11F). Assembly sensor arrangement 164 can be of any suitable configuration sufficient to differentiate position (e.g., encoder, sensor/emitter arrangement, etc.) and is in communication with control system 52 to, among other things, control assembly Depending on how 88 is positioned relative to rotating equipment 80, it may be possible to control rotating equipment 80 in different ways. Other configurations and arrangements are also contemplated.

As mentioned above, the input manipulator 92 of the manipulator assembly 88 is positioned to be engaged by the surgeon to facilitate driving the rotary instrument 80. As shown schematically in FIG. 13, rotating equipment 80 includes an actuator 166 (e.g., an electric motor) supported within an equipment housing 168 that defines a journal 158 and is rigidly attached to fixture 78. It is attached. The actuator 166 is arranged to communicate with an actuator driver (e.g., a motor controller supported on a printed circuit board), generally indicated at 170, and the actuator driver 170 is arranged to communicate with an actuator interface, indicated generally at 172 (e.g., a motor controller supported on the arm controller 56). The control system 52 is arranged to communicate with the control system 52 via a connected wiring harness. Actuator 166, actuator driver 170, and/or actuator interface 172 power rotary device 80 to selectively generate rotational torque about first axis A1 in response to engagement of input manipulator 92. Those skilled in the art will appreciate that it can be arranged or configured in a number of different ways sufficient to provide, control, or otherwise enable rotating equipment 80. Further, as will be understood from the discussion below, certain embodiments of the end effector 40 described herein, shown in connection with the first embodiment of the end effector 40, are such that the rotating device 80 is generally modular. Other embodiments of end effector 40 are not modular (e.g., removable from one or more portions of drive assembly 82); or integrated into multiple parts). Accordingly, unless otherwise indicated, the terms "actuator 166" and "rotating device 80" may be used interchangeably.

13-19C, input control 92 of control assembly 88 is configured to communicate with actuator driver 170 to facilitate how rotational torque is generated by actuator 166. Placed. For this purpose, the input operating tool 92 has a first input position I1 (see FIG. 19A) and a second input position I2 (see FIG. 19B) in order to control the rotational torque generated by the rotating device 80. The grip 90 is arranged to move between the grips 90 and 90. In the illustrated embodiment, the first input position I1 corresponds to the absence of engagement with the input manipulator 92, and the second input position I2 corresponds to full engagement of the input manipulator 92. The input manipulator 92 is also movable to other input positions between the first input position I1 and the second input position I2, such as to facilitate variable speed control of the actuator 166. will be understood.

The manipulator assembly 88 is configured to cooperate with the input manipulator 92 to communicate the physical position of the input manipulator 92 between the first input position I1 and the second input position I2 to the actuator driver 170. The rotary device 80 includes an operating transmitter 174 (see FIGS. 17 to 19C) disposed in the actuator driver 170, and the rotating device 80 communicates with the actuator driver 170 to A manipulation detector 176 (see schematically shown FIGS. 17 and 18) is provided so as to determine the position of the manipulation transmitter 174 corresponding to the movement of the input manipulation tool 92. In one embodiment, the operational emitter 174 is further defined as a magnet, and the operational detector 176 determines the relative position of the operational emitter 174 in response to a predetermined change in the magnetic field generated by the magnet. judge. In this illustrative example, manipulation detector 176 may be of any suitable type sufficient to sense and respond to changes in the magnetic field. Furthermore, the operational transmitter 174 can be fabricated from a ferrous material, and the operational detector 176 can be a Hall effect sensor that responds to changes in the magnetic field due to the interaction of the ferrous material of the operational transmitter 174. It is conceivable that this can be done. It is therefore conceivable that the operational transmitter 174 can also be realized as a steel enamel, coating, paint, etc. Other configurations are also contemplated.

Referring now to FIGS. 17-19C, a manipulation transmitter is capable of sensing movement of the input manipulation tool 92 between a first input position I1 and a second input position I2 by a manipulation detector 176. A linkage mechanism 178 is interposed between the input operating tool 92 and the operating transmitter 174 in order to convert the input operating tool 92 into a corresponding movement of the operating element 174 . Linkage 178 generally includes a cam member 180, a piston 182, a carrier 184, a fork profile 186, and a fork guide 188. The input operating tool 92 includes an operating handle 190, a pair of guide shafts 192, and an extension member 194. Guide shafts 192 extend from operating handle 190 and are slidably supported within respective bushings 196 disposed within grip 90 . Extension member 194 similarly extends away from guide shaft 192 from operating handle 190 to cutout end 198 . Cam member 180 is interposed between piston 182 and cutout end 198 of input manipulator 92 and pivots about a support shaft 200 coupled to frame 134 . On either side of the support shaft 200, the cam member 180 has an engagement surface 202 that abuts the piston 182 and a slotted projection 204 within which an extension pin 206 moves. Extension pin 206 is attached to cutout end 198 of extension member 194 and pivots cam member 180 about support shaft 200 when input manipulator 92 moves.

Piston 182 is slidably supported within piston bushing 208 that is attached to frame 134. In addition to contacting the engagement surface 202 of the cam member 180, the piston 182 also contacts the fork guide shaft 210 of the fork guide 188, which is inserted between the pair of washers 214 and the keeper 216. supports the operating biasing element 212 (see FIG. 18). A keeper 216 is attached to the fork guide shaft 210 and engages one of the washers 214 to retain the operational biasing element 212 therebetween. Washer 214 helps facilitate translation of fork guide shaft 210 in response to movement of piston 182. Here, the operating biasing element 212 is arranged to be compressed between one of the washers 214 and the frame 134 when the input operating tool moves from the first input position I1 to the second input position I2. The energy stored in the operating biasing element 212 moves the input operating tool to the first input position I1.

Fork guide 188 moves simultaneously with fork feature 186, and in the illustrated embodiment, fork feature 186 moves as input manipulator 92 moves between first input position I1 and second input position I2. It is positioned within retainer 136 for translation along first axis A1 (compare FIGS. 19A and 19B). As shown in FIG. 17, the retainer 136 simultaneously moves into the first fork shape 186 as the handle assembly 88 moves between the first handle assembly position P1 and the second handle assembly position P2. It has a shape that rotates around the axis A1.

The carrier 184 is operably attached to or otherwise supports the operational transmitter 174 for simultaneous movement and has an outer sliding contact surface 218 (see FIG. 18) and a pair of An outer blocking surface 220 is defined. Fork shape 186 defines an inner sliding contact surface 222 and a pair of inner blocking surfaces 224 . The outer sliding contact surface 218 of the carrier 184 engages the inner sliding contact surface 222 of the fork shape 186 to rotate the fork shape 186 about the first axis A1 without moving the carrier 184. The outer blocking surface 220 of the carrier 184 engages the inner blocking surface 224 of the fork profile 186 to prevent simultaneous translation of the fork profile 186 and the carrier 184 along the first axis A1. (compare FIGS. 19A-19C). As shown in FIG. 18, the equipment housing 168 of the rotating equipment 80 defines a slot 226 located adjacent to the manipulation detector 176 (shown schematically in FIG. 18). The carrier 184 includes a boss 228 that supports the movement of the fork-shaped body 186 along the first axis A1 caused by the movement of the input manipulator 92 between the first input position I1 and the second input position I2. It is supported along slot 226 to translate in response to a corresponding translation. It will be appreciated that other configurations for the various components of linkage 178 and/or manipulator assembly 88 than those shown in the figures are also contemplated.

Referring again to FIGS. 1-24, end effector 40 employs a coupler 230 operably attached to rotating equipment 80. As shown in FIGS. Coupler 230 couples drive assembly 82 to rotating instrument 80 in multiple orientations to selectively position second axis A2 relative to rotating instrument 80 along different trajectories maintained by surgical robot 32. Configured to releasably secure. This feature allows the grip 90 to be positioned generally the same way regardless of how the second axis A2 is oriented relative to the rotating device 80 and, therefore, relative to the fixture 78 of the end effector 40. This gives the surgeon a more consistent approach along each individual trajectory T (compare FIGS. 2A-2C).

The functionality described above is further illustrated by comparing the orientation of the second axis A2 and the orientation of the fixture 78 throughout FIGS. 11A-11F. Here, the fixture 78 has a reference portion, indicated generally at 232, and in this illustrative example, the reference portion 232 is defined by the general plane of the fixture 78 that abuts the coupling 38 of the robot arm 36. Realized as a vertical line. However, the reference portion 232 may also be defined by other components of the end effector 40 that remain fixed relative to the fixture 78 or otherwise (e.g., by gravity, etc.) ) may also be defined.

11A-11C, drive assembly 82 is positioned in a reference orientation OR and defined between second axis A2 and reference portion 232 of fixture 78. In FIGS. Therefore, the second axis A2 is parallel to the reference portion 232 when in the reference orientation OR. However, in FIG. 11D, the drive assembly 82 is arranged in a different first orientation O1, which is the drive for the rotating equipment 80 about a first axis A1 in a first direction of rotation R1. defined by the rotation of assembly 82. Further, in FIGS. 11E and 11F, the drive assembly 82 is positioned in a second orientation O2, which is rotation about the first axis A1 in an opposite second direction of rotation R2. Defined by the rotation of drive assembly 82 relative to instrument 80.

From the perspective views shown in FIGS. 11A to 11F, the first rotation direction R1 is counterclockwise, and the second rotation direction R2 is clockwise. Thus, when in the first orientation O1 shown in FIG. 11D, the drive assembly 82 has rotated +45 degrees counterclockwise about the first axis A1 relative to the reference portion 232. When in the second orientation O2 shown in FIGS. 11E-11F, the drive assembly 82 has rotated −45 degrees clockwise relative to the reference portion 232 about the first axis A1. Therefore, there is a difference of 90 degrees between the first orientation O1 and the second orientation O2. However, it will be appreciated that the first orientation O1 and the second orientation O2 can be defined in a number of different ways to facilitate consistent positioning of the grip 90. Additionally, it will be appreciated that coupler 230 may support drive assembly 82 in other orientations.

Referring now to FIG. 13, in the exemplary embodiment shown herein, couplers 230 are arranged radially relative to first axis A1 along respective coupling pockets 236 formed in carrier ring 238. A plurality of coupling elements 234 (eg, ball bearings) are supported for movement in a direction. Coupler 230 also includes a locking collar 240 having an inner angled surface 242 that contacts coupling element 234 . Locking collar 240 is arranged to selectively rotate about first axis A1 via a force applied to locking collar 240 by a surgeon. Carrier ring 238 is responsive to rotation of locking collar 240 relative to equipment housing 168, such as through a threaded engagement between locking collar 240 and carrier ring 238 (threaded engagement not shown in detail). It is configured to translate axially with respect to rotating device 80 .

When the locking collar 240 rotates about the first axis A1 in the second rotational direction R2, the carrier ring 238 simultaneously translates the coupling element 234 towards the actuator 166 along the first axis A1. Because of the shape of the inner angled surface 242 that contacts the coupling element 234, translation toward the actuator 166 causes the coupling element 234 to move radially inwardly toward the first axis A1 and urge the drive assembly 82. and thereby maintain the orientation of drive assembly 82 relative to fixture 78. Conversely, when the locking collar 240 rotates about the first axis A1 in the first direction of rotation R1, the carrier ring 238 simultaneously rotates away from the actuator 166 along the first axis A1. , and then the coupling elements 234 are allowed to move radially along their respective coupling pockets 236 away from the first axis A1. It will be appreciated that other configurations of combiner 230 are also contemplated. Additionally, coupler 230 is configured to secure drive assembly 82 to rotating equipment 80 in any number of different orientations, or in only predefined orientations (e.g., via a lock or detent mechanism). be able to.

It will be appreciated that the coupler 230 effectively forms an additional joint between the base 34 of the surgical robot 32 and the tool 42. To communicate the orientation of drive assembly 82 with respect to fixture 78, an orientation sensor arrangement, shown schematically at 244 in FIG. It is interposed between the assembly 82 and the assembly 82 . To this end, the orientation sensor arrangement 244 includes an orientation emitter 246 operably attached to the drive assembly 82 and an orientation emitter 246 that is connected to the rotating equipment 80 to determine the position of the orientation emitter 246 with respect to the rotating equipment 80 . and an orientation detector 248 operably attached to 80 . Again, orientation sensor arrangement 244 may be of a number of different types, configurations, and/or arrangements. Alternatively, the selected orientation may be manually entered into surgical system 30, such as via input device 70 of user interface 66 (see FIG. 1).

21-24, as discussed above, drive assembly 82 transmits rotation from rotating equipment 80 or manual interface 94 to tool 42 attached to connector 86 via gear train 84. used for To this end, drive assembly 82 includes a generally L-shaped driver 250 that aligns a power input shaft 252 along a first axis A1 (see FIG. 23A), as described in more detail below. and further supports manual input shaft 254, holding shaft 255, and intermediate shaft 256 along second axis A2. Power input shaft 252 includes a power coupler 258 that is shaped to engage a corresponding actuator coupler 260 (see FIG. 13) coupled to actuator 166 for simultaneous rotation. (e.g. as an interference-type "dog clutch"). Power input shaft 252, manual input shaft 254, retention shaft 255, and intermediate shaft 256 each generally include one or more bearings 262 (e.g., sealed ball bearings), washers 264, keepers 266, and/or spring shims. 268 (the arrangement is shown schematically in FIGS. 23A-23B and 24 and will not be described in detail). Drive assembly 82 further includes a seal 270 positioned adjacent the exposed end of each of power input shaft 252 , manual input shaft 254 , and retention shaft 255 .

To convert rotation about the first axis A1 to rotation about the second axis A2, the gear train 84 includes at least one bevel gear set, indicated generally at 272, where the bevel gear set 272 The connector 86 is interposed so as to be rotationally connected to the connector 86. Bevel gear set 272 includes an input gear 274 and an output gear 276. Input gear 274 rotates simultaneously with power input shaft 252 through a key and keyway arrangement generally indicated at 278 . Input gear 274 is arranged to mesh with output gear 276 (see FIG. 23A), as described in more detail below. Output gear 276 rotates simultaneously with intermediate shaft 256 via a spline arrangement generally indicated at 280. Here, the intermediate shaft 256 includes an outer spline 282 that engages a corresponding inner spline 284 of the output gear 276, as described in more detail below.

In the illustrated embodiment, gear train 84 of drive assembly 82 includes at least one reduction gear set, generally indicated at 286, which is interposed for rotational communication between rotating equipment 80 and connector 86. Therefore, rotation of actuator 166 of rotating device 80 occurs at a different (eg, faster or slower) speed than the rotation of tool 42 attached to connector 86. More specifically, a reduction gear set 286 is interposed in rotational communication between the bevel gear set 272 and the connector 86 and is rotatable via the intermediate shaft 256 (rotating device 80 or manual interface 94). The holding shaft 255 (which rotates about the second axis A2 at the same time as the tool 42) is arranged to rotate at a faster speed than the holding shaft 255 (which rotates about the second axis A2 at the same time as the tool 42). In the first embodiment of the end effector 40, the rotation of the actuator 166 about the first axis A1 occurs at a faster rate than the rotation of the tool 42 about the second axis A2, whereas other configurations is also contemplated, and as used herein, the term "reduction gear set" refers to a reduction in rotational speed (by increasing torque) or a reduction in torque (by increasing rotational speed), unless specifically stated otherwise. be able to.

23A-24, in the illustrated embodiment, the reduction gear set 286 comprises a compound planetary reduction gear set having a fixed ring gear 288 formed within the driver 250 (FIG. 23A-24). 23B), the ring gear 288 is arranged to mesh with the first set of planetary gears 290A, the second set of planetary gears 290B, and the third set of planetary gears 290C; The set of planetary gears 290A, the second set of planetary gears 290B, and the third set of planetary gears 290C are connected to the first sun gear 292A, the second sun gear 292B, and the third sun gear 292C, respectively. are arranged in mating engagement. The first set of pins 294A, the second set of pins 294B, and the third set of pins 294C are connected to the first set of bushings 296A, the second set of bushings 296B, and the third set of bushings 296C. In cooperation with this, the planetary gears of the respective sets of planetary gears 290A, 290B, and 290C are rotatably supported to rotate. These sets of pins 294A, 294B, 294C are fixed to a first carrier 298A, a second carrier 298B, and a third carrier 298C, respectively. A first carrier 298A is defined by or otherwise operably attached to the retaining shaft 255 and retains a first set of planetary gears 290A, and a first carrier 298A is defined by or otherwise operably attached to the retaining shaft 255 and retains a first set of planetary gears 290A. 290A is also positioned in meshing engagement with first sun gear 292A. A first sun gear 292A is coupled for simultaneous rotation to a second carrier 298B, which carries a second set of planet gears 290B, and a second set of planet gears 290B. 290B is also positioned in meshing engagement with a second sun gear 292B. A second sun gear 292B is coupled for simultaneous rotation to a third carrier 298C, which carries a third set of planetary gears 290C and a third set of planetary gears 290C. 290C is also positioned in meshing engagement with a third sun gear 292C. Third sun gear 292C is coupled to intermediate shaft 256 for simultaneous rotation. A washer 264 can be provided adjacent one or more of the carriers 298A, 298B, 298C to help reduce friction with adjacent sets of planetary gears 290A, 290B, 290C. Those skilled in the art will appreciate that the reduction gear set 286 can also be arranged or configured in a number of different ways, such as with less than two planetary reductions, more than four planetary reductions, or no planetary reductions. It will be. Other configurations are also contemplated.

23A-24, to facilitate releasable attachment to the bit interface 128 of the tool 42, the connector 86 of the drive assembly 82 generally includes a connector body 300, a flange member 302, a connector biasing element 304, a pair of axial connector elements 306, and a rotational connector element 308. Connector body 300 is operably attached to drive body 250 (eg, via a threaded engagement) and houses a bearing 262 that rotatably supports retaining shaft 255 about second axis A2. Retaining shaft 255 includes connector element pockets 310, each of which extends in the axial direction of bit interface 128 of tool 42 to constrain relative axial movement between tool 42 and retaining shaft 255. One of the axial connector elements 306 is received to engage the retainer 130.

To release tool 42, flange member 302 is arranged to translate along second axis A2 and slides along connector body 300 in response to a force applied by the surgeon. be able to. Flange member 302 includes an axially ramped surface 312 that contacts axial connector element 306 . Connector biasing element 304 is interposed between connector body 300 and flange member 302 to move flange member 302 axially away from connector body 300 . The flange member 302 is prevented from disengaging from the connector body via the stepped surface 314 of the seal 270 coupled to the retaining shaft 255. Due to the engagement between the axial connector element 306 and the axially inclined surface 312 of the flange member 302, the biasing provided by the connector biasing element 304 causes the axial connector element 306 to radially move toward the second axis A2. directionally inwardly to engage the axial retainer 130 of the bit interface 128 of the tool 42 , resulting in axial retention of the tool 42 relative to the drive assembly 82 . In the illustrated embodiment, the rotary connector element 308 of the connector 86 is formed at the distal end of the retention shaft 255 and is shaped to abut the rotary retainer 132 of the bit interface 128 of the tool 42, thereby 42 and holding shaft 255 occur simultaneously. Other configurations of connector 86 are also contemplated.

With continued reference to FIGS. 23A-24, drive assembly 82 includes a clutch mechanism, indicated generally at 316, which is interposed between manual interface 94 and gear train 84. Clutch mechanism 316 is operable between a first mode 316A (see FIG. 23A) and a second mode 316B (see FIG. 23B). In the first mode 316A, rotational torque generated by actuator 166 of rotating equipment 80 is transmitted by gear train 84 to rotate tool 42 about second axis A2 without rotating manual interface 94. . In the second mode 316B, the force applied to the manual interface 94 is transmitted as a torque by the gear train 84 to rotate the tool 42 about the second axis S2. As described in more detail below, the clutch mechanism 316 moves from the first mode 316A to the second mode 316B in response to a force applied to the manual interface 94, causing the clutch mechanism 316 to move from the second mode 316B to the second mode 316B. 1 and a clutch biasing element 318 arranged to move to mode 316A.

As best shown in FIGS. 23A-23B, clutch biasing element 318 is supported within a clutch pocket 320 formed within intermediate shaft 256 adjacent outer spline 282. As best shown in FIGS. Clutch biasing element 318 is also positioned to engage output gear 276 of bevel gear set 272 of gear train 84 . Because output gear 276 engages outer spline 282 of intermediate shaft 256 using inner spline 284 but is not axially fixed to intermediate shaft 256, clutch biasing element 318 directs output gear 276 toward the second shaft. A2 into meshing engagement with input gear 274 to facilitate operating clutch mechanism 316 in first mode 316A (see FIG. 23A).

To facilitate alignment with second axis A2, the proximal end of intermediate shaft 256 includes a pilot shaft region 322 adjacent outer spline 282, which pilot shaft region 322 is connected to manual interface 94. (See FIGS. 23A-23B). Manual input shaft 254 also includes an idle hole 326 at its distal end, and a link spline arrangement 328 is axially disposed between idle hole 326 and pilot hole 324. The outer surface of manual input shaft 254 is rotatably supported by a bearing 262 that is housed within a seat 330 that is attached to driver 250 . The manual input shaft 254 extends through the top cover 332, which is also attached to the driver 250 and, thus, is provided in close proximity to the manual input shaft 254 by the handle assembly 96, as described in more detail below. can be engaged with the front end.

When the clutch mechanism 316 is in a first mode 316A (see FIG. 23A), the idle hole 326 of the manual input shaft 254 contacts the outer spline 282 of the intermediate shaft 256 but does not rotate therewith. Furthermore, due to how the idle hole 326 and link spline arrangement 328 are positioned, when the clutch mechanism 316 is in the first mode 316A, rotation of the intermediate shaft 256 is not transmitted to the manual input shaft 254 and the bevel gear set Gears 274, 276 of 272 remain meshed, and thus rotation of power input shaft 252 is transmitted to intermediate shaft 256. However, when an axial force is applied to manual interface 94, manual input shaft 254 translates toward connector 86 along second axis A2 simultaneously with output gear 276. As shown in FIG. 23B, this causes output gear 276 to disengage from meshing engagement with input gear 274, thereby ceasing rotation between axes A1, A2 and intermediate link spline arrangement 328 of manual input shaft 254. It further engages outer splines 282 of shaft 256, thereby facilitating simultaneous rotation of manual input shaft 254 and intermediate shaft 256.

Accordingly, the axial force applied to manual interface 94 moves clutch mechanism 316 from first mode 316A (see FIG. 23A) to second mode 316B (see FIG. 23B). This configuration virtually prevents the transmission of rotational torque between rotating equipment 80 and manual interface 94. In other words, when the clutch mechanism 316 is in the first mode 316A, driving the rotating device 80 will not rotate the manual interface 94, and applying a force to rotate the manual interface 94 will cause the rotating device 80 to move backwards. not driven to. Other configurations of clutch mechanism 316 are also contemplated beyond those described herein and shown in connection with the first embodiment of end effector 40.

As shown in FIGS. 23A-23B, the above-described embodiments of drive assembly 82 and manual interface 94 cooperate to define a guide hole, generally indicated at 334, which guide hole 334 is aligned with second axis A2. It extends along from manual interface 94 through various components of drive assembly 82 to connector 86 . Here, a guidewire GW (e.g., a "K-wire") can extend through the guide hole 334 (not shown in detail), as can the cannulated fixture 50 and the rotary drive tool 48. , generally known in the related art).

11B-11C, as discussed above, the handle assembly 96 is attached to the manual interface 94 and, among other things, in response to a force applied to the handle assembly 96 by the surgeon, moves the tool 42 into the second position. about axis A2 and is used to translate manual input shaft 254 along second axis A2. To this end, manual interface 94 includes a head 336 arranged for rotation about second axis A2, and handle assembly 96 generally includes a power transmission 338 and a handle body 340. The head 336 is disposed at the proximal end of the manual input shaft 254 and the power transmission device 338 is configured to rotate simultaneously about a second axis A2 in response to a force applied to the handle body 340 by the surgeon. , is shaped to receive the head 336. As shown schematically in FIGS. 11B-11C, the handle assembly 96 can include a ratchet mechanism 342 that is interposed between the handle body 340 and the power transmission 338 to 340 and the power transmission device 338 simultaneously rotate about the second axis A2 in a third rotational direction R3, and the power transmission device 338 rotates about the second axis A2 relative to the handle body 340 in a third rotational direction R3. The rotation in the fourth rotation direction R4, which is opposite to the rotation direction R3 of No. 3, is stopped. It will be appreciated that the ratchet mechanism 342 can be of a number of different types and configurations (eg, a ratchet and pawl arrangement, one or more resiliently flexible members, etc.). Additionally, although in the illustrated embodiment, the handle assembly 96 is releasably attachable to the manual interface 94, the handle assembly 96 can also be permanently secured to the manual interface 94 (e.g., collapsible or other (by means of a handle body 340 that can be joined by a method).

The present disclosure is also directed to a method of forming a pilot hole 46 in a surgical site ST along a trajectory T maintained by the surgical robot 32. The method includes different steps including attaching end effector 40 supporting rotating instrument 80, drive assembly 82, manual interface 94, and manipulator assembly 88 to surgical robot 32. The method also includes attaching the rotary cutting tool 44 to the drive assembly 82 along a second axis A2 and aligning the second axis A2 with the trajectory T to position the rotary cutting tool 44 at the surgical site. and engaging manipulator assembly 88 to generate rotational torque about first axis A1 by rotating device 80 and generating torque about first axis A1 from rotating device 80 by drive assembly 82. and rotating the rotary cutting tool 44 about the second axis A2. The method further includes advancing the rotary cutting tool 44 along the trajectory T at the surgical site ST to a first depth D1 and ceasing rotation about the first axis A1. The method also includes positioning the handle assembly 88 to present or otherwise facilitate access to the manual interface 94 and applying a force to the manual interface 94 to move the rotary cutting tool 44 to the second and advancing the rotary cutting tool 44 along a trajectory T at the surgical site ST to a second depth D2 that is greater than the first depth D1.

The present disclosure is also directed to a method of installing a fixture 50 at a surgical site ST along a trajectory T maintained by a surgical robot 32. The method includes different steps including attaching end effector 40 supporting rotating instrument 80, drive assembly 82, manual interface 94, and manipulator assembly 88 to surgical robot 32. The method also includes attaching the tool 42 to the drive assembly 82 along a second axis A2, attaching the fixture 50 to the tool 42, aligning the second axis A2 with the track, and aligning the fixture 50 with the track. 50 adjacent the surgical site ST. The method includes engaging a handle assembly 88 to generate a rotational torque about a first axis A1 by the rotating device 80, and generating a torque about the first axis A1 from the rotating device 80 by a drive assembly 82. and rotating the tool 42 and the fixture 50 about the second axis A2. The method also includes advancing tool 42 and fixture 50 along a trajectory at surgical site ST to a first depth D1, ceasing rotation about first axis A1, and manual interface 94. and positioning the manipulator assembly 88 to present or otherwise facilitate access to. The method includes applying a force to manual interface 94 to rotate tool 42 and fixture 50 about a second axis A2 and moving fixture 50 along a trajectory at a surgical site ST to a first depth. and advancing to a second depth D2 that is greater than the depth D1.

The present disclosure is also directed to a method of installing first and second fixtures 50 at a surgical site ST along respective first and second trajectories T1 and T2 maintained by surgical robot 32. . The method includes different steps including attaching end effector 40 supporting rotating instrument 80, drive assembly 82, manual interface 94, and manipulator assembly 88 to surgical robot 32. The method also includes attaching the tool 42 to the drive assembly 82 along a second axis A2, attaching the first fixture 50 to the tool 42, and aligning the second axis A2 with the first trajectory and position. Coupled with positioning the first fixture 50 adjacent the surgical site ST and engaging the manipulator assembly 88 to generate a rotational torque about the first axis A1 by the rotating device 80. , converting torque about the first axis A1 from the rotating equipment 80 by the drive assembly 82 to rotate the tool 42 and the first fixture 50 about the second axis A2. The method includes advancing the tool 42 and the first fixture 50 along a first trajectory at a surgical site ST to a first depth D1 and ceasing rotation about a first axis A1. and positioning the handle assembly 88 to present or otherwise facilitate access to the manual interface 94. The method also includes applying a force to manual interface 94 to rotate tool 42 and first fixture 50 about second axis A2 and moving the tool along a first trajectory at surgical site ST. 42 and the first fixture 50 to a second depth D2 that is greater than the first depth D1, and releasing the first fixture 50 from the tool 42. The method includes attaching a second fixture 50 to the tool 42 and aligning a second axis A2 with a second trajectory to position the second fixture 50 adjacent a surgical site ST. and engaging the manipulator assembly 88 to generate a rotational torque about the first axis A1 by the rotating device 80. The method also includes converting torque about the first axis A1 from the rotating device 80 by the drive assembly 82 to rotate the tool 42 and the second fixture 50 about the second axis A2. , advancing the tool 42 and the second fixture 50 along a second trajectory at the surgical site ST to a third depth D3 and ceasing rotation about the first axis A1; and positioning the manipulator assembly 88 to present or otherwise facilitate access to the interface 94. The method includes applying a force to manual interface 94 to rotate tool 42 and second fixture 50 about a second axis A2 and moving tool 42 along a second trajectory at a surgical site ST. and advancing the second fixture 50 to a fourth depth D4 that is greater than the third depth D3.

As mentioned above, a second embodiment of the end effector of surgical system 30 is shown in FIGS. 25A-28. In the following description, structures and components of the second embodiment that are the same as or otherwise correspond to structures and components of the first embodiment of the end effector 40 have the same reference numerals incremented by 2000. Has a number. Many of the components and features of the second embodiment of end effector 2040 are substantially similar to those of the first embodiment of end effector 40 described above, thereby providing clarity, consistency, and conciseness. For purposes of this, only certain specific differences between the second embodiment of end effector 2040 and the first embodiment of end effector 40 are discussed below, and common components and components between these embodiments are discussed below. Only some of the features are discussed herein and illustrated in the drawings. Accordingly, and without limitation, unless otherwise indicated below, the description of the first embodiment of end effector 40 may be incorporated by reference into the second embodiment of end effector 2040. .

25A-28, a second embodiment of an end effector 2040 comprising a fixture 2078, a rotating device 2080 and its actuator 2166 (schematically shown), and a drive assembly 2082 is shown schematically. has been done. Compared to the first embodiment described above, the second embodiment of end effector 2040 generally employs a different configuration of rotating instrument 2080, drive assembly 2082, and manipulator assembly 2088, each of which is described below. This will be explained in more detail below.

As best shown in FIGS. 25A-26, in a second embodiment, rotating equipment 2080 and drive assembly 2082 are configured such that second axis A2 is fixed relative to first axis A1. . In other words, in this embodiment, the driver 2250 of the drive assembly 2082 is not arranged to move relative to the rotating equipment 2080. Here, coupler 2230 is operably attached to drive assembly 2082 to releasably secure the drive subassembly, shown generally at 2344, along second axis A2. As best shown in FIG. 28, the drive subassembly 2344 includes a reduction gear set 2286, which also has a planetary configuration and is coupled to a connector 2086 and a third sun gear 2292C. and a drive subassembly coupling 2346. When drive subassembly 2344 is operably attached to coupler 2230, drive subassembly coupling 2346 engages intermediate output coupling 2348 coupled to intermediate shaft 2256 of drive assembly 2082, in this embodiment , intermediate shaft 2256 also serves as manual input shaft 2254. Although not shown in the drawings of the second embodiment of end effector 2040, connector 2086 of drive subassembly 2344 differs in the same manner as connector 86 described above in connection with the first embodiment of end effector 40. It will be appreciated that tools of the type can also be releasably secured.

Here in the second embodiment, intermediate shaft 2256 of drive assembly 2082 defines head 2336 of manual interface 2094 and is coupled to output gear 2276 of bevel gear set 2272 of gear train 2084. The head 2336 of the manual interface 2094 similarly receives applied force from the user and generates a rotational force used to rotate the tool (not shown in FIGS. 25A-28) about a second axis A2. arranged to convert it into torque. As described in more detail below, the handle assembly 2088 of the second embodiment of the end effector 2040 is not configured to restrict access to the manual interface 2094 at either handle assembly position P1, P2. Conversely, in this embodiment, the end effector 2040 further comprises a protective cover, indicated generally at 2350, that is operably attached to the drive assembly 2082 and located in the first protective position U1 (see FIG. 25A). It is arranged to move relative to a second axis A2 between a second protection position U2 (see FIG. 25B).

In the first protected position U1, the second axis A2 intersects at least a portion of the protective cover 2350 to limit access to the manual interface 2094 (see FIG. 25A). In the second protective position U2, the protective cover 2350 is spaced from the second axis A2 to facilitate access to the manual interface 2094 (see FIG. 25B). To this end, as best shown in FIGS. 25A-25B and FIG. Shaped to accommodate at least a portion of the interface 2094 or otherwise restrict access to at least a portion of the manual interface 2094. The protection body 2352 includes a protection hinge 2356 that pivots around a protection axis UA between a first protection position U1 (see FIG. 25A) and a second protection position U2 (see FIG. 25B). is operably attached to drive assembly 2082 . In the illustrated embodiment, the protection axis UA is arranged substantially perpendicular to both the first axis A1 and the second axis A2.

It will be appreciated that utilizing the protective cover 2350 allows the end effector 2040 to limit or otherwise inhibit access to the manual interface 2094 without necessarily relying on movement of the manipulator assembly 2088. It will be. Accordingly, in the second embodiment, the manipulator assembly 2088 is nevertheless positioned between the first manipulator assembly position P1 (see FIG. 25A) and the second manipulator assembly position P2 (see FIG. 25B). is arranged to move with the retainer 2136, but no part of the handle assembly 2088 restricts or otherwise inhibits access to the manual interface 2094 in either handle assembly position P1, P2. .

The grip 2090 of the manipulator assembly 2088 has a generally cylindrical shape, and when in the first manipulator assembly position P1 (see FIG. 25A), the grip 2090 of the manipulator assembly 2088 has a second grip such that the hand is generally neutrally engaged. When in the manipulator assembly position P2 (see FIG. 25B), the hand is configured to engage in a generally pronated or supinated manner. Again, in this embodiment, the manipulator assembly 2088 is arranged to move simultaneously with the retainer 2136, such that the manipulator assembly 2088 is disposed in a first manipulator assembly position P1 (see FIG. 25A) or input control 2092 is placed between the first input position I1 (see FIG. 27A) and the second input position I2 (see FIG. 27B), whether the input control 2092 is placed in the second input position I1 (see FIG. ) can be moved between.

Referring now to FIGS. 26-27B, in this embodiment, manipulator assembly 2088 is similarly configured such that movement of input manipulator 2092 results in a corresponding movement of piston 2182 (FIGS. 27A-28B). ), the piston 2182 engages and moves the fork guide 2188 of the retainer 2136 (see FIG. 26). As shown in FIGS. 27A-27B, in this embodiment, the linkage 2178 includes a sliding member 2358 that provides input between a first input position I1 and a second input position I2. It is supported within the grip 2090 so as to move simultaneously with the operating tool 2092. Here, sliding member 2358 defines two sliding ramps 2360 that engage respective bearings 2262 supported on piston 2182 and extension member 2194 of input manipulator 2092. , transmits motion from input manipulator 2092 to piston 2182 (compare FIGS. 27A-27B). Although not shown, it will be appreciated that the linkage 2178 may also include additional components (eg, biasing elements, bushings, fasteners, seals, etc.). Other configurations are also contemplated.

As mentioned above, a third embodiment of the end effector of surgical system 30 is shown in FIGS. 29A-31B. In the following description, structures and components of the third embodiment that are the same as or otherwise correspond to structures and components of the first embodiment of end effector 40 have the same reference numerals incremented by 3000. Has a number. Many of the components and features of the third embodiment of end effector 3040 are substantially similar to those of the first embodiment of end effector 40 described above, thereby providing clarity, consistency, and conciseness. For purposes of this, only certain specific differences between the third embodiment of end effector 3040 and the first embodiment of end effector 40 are discussed below, and common components and components between these embodiments are discussed below. Only some of the features are discussed herein and illustrated in the drawings. Accordingly, and without limitation, unless otherwise indicated below, the description of the first embodiment of end effector 40 may be incorporated by reference into the third embodiment of end effector 3040. .

29A-31B, a third embodiment of an end effector 3040 comprising a fixture 3078, a rotary instrument 3080 and its actuator 3166 (schematically shown), and a drive assembly 3082 is shown schematically. has been done. As compared to the first embodiment described above, the third embodiment of the end effector 3040 generally uses a different configuration of the handle assembly 3088 and the drive assembly 3082 to operate the tool 3042 with a different type of bit interface 3128. and each of which is described in more detail below.

As best shown in FIGS. 29A-30, in a third embodiment, drive assembly 3082 is similarly configured to be releasably attached to rotating equipment 3080 via coupler 3230, and thus the drive assembly By positioning 3082 differently about the first axis A1, the second axis A2 can be moved relative to the first axis A1. In a third embodiment, manipulator assembly 3088 uses a grip 3090 and input manipulator 3092 that are structurally similar to the second embodiment of manipulator assembly 2088 described above. However, in a third embodiment, the frame 3134 of the manipulator assembly 3088 is generally configured to move simultaneously between multiple manipulator assembly positions (a first manipulator assembly position P1 is shown in FIGS. 29A-29B). A first frame body 3362 coupled to a retainer 3136 and a plurality of grip positions including a first grip position G1 (see FIG. 29A) and a second grip position G2 (see FIG. 29B). A second frame body 3364 is provided that supports a grip 3090 and an input operating tool 3092 so as to be movable relative to the body 3362.

When in the first grip position G1 shown in FIG. 29A, at least a portion of the second frame body 3364 restricts access to the manual interface 3094, and the input controls 3092, as described in more detail below, When engaged by a user, the rotating device 3080 is arranged to drive the tool 3042, which is secured to the connector 3086, to rotate about the second axis A2. However, when in the second grip position G2 shown in FIG. 29B, the second frame body 3364 facilitates receiving applied force from the user to rotate the tool 3042 about the second axis A2. The manual interface 3094 is arranged in a spaced relation to the manual interface 3094 so as to be symmetrical. Although not shown in connection with the third embodiment, the second frame body 3364 may also rely on movement between multiple grip positions (e.g., a first grip position G1 and a second grip position G2). rather, it is arranged to move simultaneously with the first frame body 3362 between a plurality of manipulator assembly positions (a first manipulator assembly position P1 is shown in FIGS. 29A-29B).

In a third embodiment of the end effector 3040, the second frame body 3364 is arranged to translate between a first grip position G1 and a second grip position G2, and this movement substantially parallel to axis A1. To this end, the second frame body 3364 includes a rider 3366 that is supported to slide along a track 3368 defined within the first frame body 3362. This configuration is exemplary, and the first frame body 3362 and the second frame body 3364 are configured such that the second frame body 3364 selectively inhibits and/or facilitates access to the manual interface 3094. It will be appreciated that it can also be configured in a number of different ways sufficient to allow movement relative to one frame body 3362. As an illustrative example, movement between the first grip position G1 and the second grip position G2 may be caused by other types of translational movements (e.g. sliding along a curved path or along the first axis A1). (sliding in non-parallel directions), rotational movement, or other types of movement. Other configurations are also contemplated.

30-31B, as discussed above, a third embodiment of an end effector 3040 is configured to secure a tool 3042 with a different type of bit interface 3128 via a connector 3086. FIG. 30 shows two exemplary tools implemented as a rotary cutting tool 3044 (e.g., a drill bit) and a rotary drive tool 3048 (e.g., a multi-axis screwdriver) supporting a fixture 3050 (e.g., a multi-axis screw). 3042 is shown. The bit interface 3128 of the rotary drive tool 3048 is configured in the same manner as the bit interface 128 used with the first embodiment of the end effector 40, except that the bit interface 3128 of the illustrated rotary cutting tool 3044 is configured with axial retention. 3130 and an extension portion 3370 that extends away from the rotating retainer 3132. As described in more detail below, in a third embodiment, an extension 3370 of the bit interface 3128 of the rotary cutting tool 3044 cooperates with a transmission, generally designated 3372, of the drive assembly 3082. Facilitates operating gear train 3084 at different drive ratios.

As best shown in FIGS. 31A-31B, for the drive assembly 3082 of the third embodiment of the end effector 3040, the power input shaft 3252 is operably attached (e.g., via a fastener) to the drive body 3250. The input body 3374 is supported by a bearing 3262 located within the input body 3374. Again, input gear 3274 of bevel gear set 3272 is coupled to power input shaft 3252 and arranged to rotate about first axis A1. However, in this embodiment, output gear 3276 of bevel gear set 3272 is coupled to idler shaft 3376. Here, idler shaft 3376 is supported by a bearing 3262 located within top cover 3332 and intermediate body 3378, with intermediate body 3378 disposed between top cover 3332 and drive body 3250. The idler shaft 3376 rotates about an idler axis IA that is disposed substantially parallel to and spaced from the second axis A2. An intermediate shaft 3256 of the drive assembly 3082, which also serves as a manual input shaft 3254 in this embodiment, is similarly supported by a bearing 3262 located within the top cover 3332 and intermediate body 3378 and rotates about a second axis A2; It is coupled to third sun gear 3292C of reduction gear set 3286. A pulley, generally designated 3380, is supported on intermediate shaft 2256 and idler shaft 3376, respectively, and pulley 3380 is interconnected via an endless belt 3382 such that intermediate shaft 3256 and idler shaft 3376 rotate simultaneously. . In the illustrated embodiment, the pulleys 3380 have the same configuration as each other, but in some embodiments, the pulleys 3380 have different configurations, such as to provide increased rotational speed or torque between the intermediate shaft 3256 and the idler shaft 3376. It will be appreciated that pulleys of different sizes may also be utilized. Additionally, although not shown herein, it will be appreciated that in some embodiments, the drive assembly 3082 may also employ a tensioner to take up slack in the endless belt 3382. Additionally, it is contemplated that in other embodiments, a chain and sprocket arrangement may be used in place of the illustrated endless belt 3382 and pulley 3380 arrangement. Other configurations are also contemplated.

The drive assembly 3082 of the third embodiment of the end effector 3040 similarly uses a planetary configuration for the reduction gear set 3286, but the various components are arranged differently to effect movement of the transmission 3372. be done. To this end, rather than being arranged in meshing engagement with ring gear 3288, first set of planet gears 3290A, second set of planet gears 3290B, and third set of planet gears 3290C are each , is arranged to meshingly engage internal teeth 3384 of conversion collar 3386 of transmission 3372 . As described in more detail below, internal teeth 3384 of conversion collar 3386 are also arranged to selectively engage shaft teeth 3388 of intermediate shaft 3256 in a splined engagement, with conversion collar 3386 It further includes external teeth 3390 arranged to selectively engage in a splined engagement. Additionally, in this embodiment, ring gear 3288 is formed as a separate component supported within driver 3250 between a pair of bushings 3196.

With continued reference to FIGS. 31A-31B, the transmission 3372 of the drive assembly 3082 is generally configured to interpose in rotational communication between the rotary device 3080 (see FIGS. 29A-30) and the connector 3086. , a first gear set GS1, a second gear set GS2, and a conversion collar 3386. Here, the conversion collar 3386 is arranged to move along the second axis A2 between a first color position CP1 (see FIG. 31A) and a second color position CP2 (see FIG. 31B).

At the first collar position CP1, the conversion collar 3386 engages the first gear set GS1 to convert rotation between the rotary device 3080 and the connector 3086 at a first drive ratio DR1. In this embodiment, the first gear set GS1 is defined by a spline engagement between the ring gear 3288 and the external teeth 3390 of the conversion collar 3386, such that the conversion collar 3386 is effectively "fixed" to the drive body 3250. ” (see FIG. 31A). Thus, in the first collar position CP1, rotation of the intermediate shaft 3256 caused from a torque generated via the rotating device 3080 or a force applied to the head 3336 of the manual interface 3094 is caused by the planetary reduction gear set 3286 is transmitted to the holding shaft 3255 of.

At the second collar position CP2, the conversion collar 3386 engages the second gear set GS2 to connect the rotary device 3080 and the connector 3086 at a second drive ratio DR2 that is different from the first drive ratio DR1. Convert the rotation with . In this embodiment, the second gear set GS2 is defined by a spline engagement between the internal teeth 3384 of the conversion collar 3386 and the shaft teeth 3388 of the intermediate shaft 3256, such that the conversion collar 3386 is and simultaneously rotates around the second axis A2 with the intermediate shaft 3256 (see FIG. 31B). Thus, in the second collar position CP2, rotation of the intermediate shaft 3256 caused from a torque generated via the rotating device 3080 or a force applied to the head 3336 of the manual interface 3094 causes the planetary reduction gear set 3286 to effectively is bypassed and transmitted directly to the retaining shaft 3255 of the connector 3086 by the conversion collar 3386. In other words, in the second collar position CP2, the intermediate shaft 3256 rotates at the same speed as the connector 3086 (and thus the stationary tool 3042).

In the illustrated embodiment, the transmission 3372 includes a transmission linkage, generally designated 3392, that converts the transmission linkage for simultaneous movement between a first collar position CP1 and a second collar position CP2. Operaably attached to collar 3386. Here, in this embodiment, the transmission linkage 3392 includes a diverter 3394 movably supported by a brace 3396 operably attached to the retaining shaft 3255 of the connector 3086. In this embodiment, the diverter 3394 is shaped and arranged to slide along braces 3396 that each support a pin of the first set of pins 3294A of the reduction gear set 3286.

As best shown in FIG. 31B, the diverter 3394 also engages an extension 3370 of the bit interface 3128 of the rotary cutting tool 3044 when the rotary cutting tool 3044 is secured to the connector 3086 of the drive assembly 3082. The conversion collar 3386 is arranged to move to the second color position CP2. Conversely, as shown in FIG. 31A, the switch 3394 is different from the extension 3370 of the bit interface 3128 of the rotary cutting tool 3044 shown in FIG. , so that when the rotary drive tool 3048 is secured to the connector 3086 of the drive assembly 3082, it is arranged to move the conversion collar 3386 to the first collar position CP1. In the illustrated embodiment, the transmission 3372 also includes a linkage biasing element 3398 (e.g., a compression spring, one or multiple spring washers).

It will be appreciated that the functionality provided by the transmission 3372 allows the drive assembly 3082 to drive the tool 3042 at a first drive ratio DR1 or a second drive ratio DR2 depending on the presence or absence of the extension 3370. Good morning. Accordingly, tool 3042 can be designed with or without extension portion 3370 based on, among other things, the intended rotational speed range in use. Additionally, this configuration advantageously allows transmission 3372 to provide additional user interaction beyond securing tool 3042 to connector 3086 (e.g., "manually" shifting or otherwise selecting gear sets). Based on the fixed tool 3042 configuration, it is possible to "shift" between gear sets GS1, GS2 "automatically" without the need for

The transmission 3372 provides "automatic" shifting between gear sets GS1, GS2 to facilitate driving different tools 3042 with different drive ratios DR1, DR2, but in connection with other embodiments, the following It will be appreciated that drive assembly 3082 may also be configured to facilitate driving at different drive ratios DR1, DR2 without necessarily utilizing transmission 3372, as described in more detail. Additionally, while the transmission 3372 described above is configured to facilitate movement of the conversion collar 3386 through engagement between the diverter 3394 and the extension 3370 of the tool 3042, the diverter 3394 is It will be appreciated that the extension portion 3370, other than that shown in FIG. 30 and FIG. 31B, may be configured to engage different portions of the tool 3042. Other configurations are also contemplated.

As mentioned above, a fourth embodiment of the end effector of surgical system 30 is shown in FIGS. 32-34C. In the following description, structures and components of the fourth embodiment that are the same or otherwise correspond to structures and components of the first embodiment of end effector 40 have the same reference numerals incremented by 4000. Has a number. Many of the components and features of the fourth embodiment of end effector 4040 are substantially similar to those of the first embodiment of end effector 40 described above, thereby providing clarity, consistency, and conciseness. For purposes of this, only certain specific differences between the fourth embodiment of end effector 4040 and the first embodiment of end effector 40 are discussed below, and common components and components between these embodiments are discussed below. Only some of the features are discussed herein and illustrated in the drawings.

Accordingly, and without limitation, unless otherwise indicated below, the description of the first embodiment of end effector 40 may be incorporated by reference into the fourth embodiment of end effector 4040. . Similarly, certain components and features of the fourth embodiment of end effector 4040 that are similar to corresponding components and features of previous embodiments have the same reference numerals for all intervening embodiments. may be referred to in the drawings or otherwise shown as having numbers 1000 plus 1000 (e.g., in the case of the fourth embodiment, the The components described above should increase by 1000, and the components described in connection with the second embodiment should increase by 2000).

32-34C, a fourth embodiment of an end effector 4040 comprising a fixture 4078, a rotary device 4080 and its actuator 4166 (schematically shown), and a drive assembly 4082 is shown schematically. has been done. Compared to the first embodiment described above, a fourth embodiment of an end effector 4040 generally employs a different configuration of a handle assembly 4088 and a drive assembly 4082 that interact with a different configuration of a handle assembly 4096. , are configured to secure the tool 4042 by different types of bit interfaces 4128, each of which will be described in more detail below.

As best shown in FIGS. 32-33, in a fourth embodiment, drive assembly 4082 is similarly configured to be releasably attached to rotary equipment 4080 via coupler 4230, and thus the drive assembly By positioning 4082 differently about the first axis A1, the second axis A2 can be moved relative to the first axis A1. In a third embodiment, the manipulator assembly 4088 uses a contoured grip 4090 and an input manipulator 4092 that is structurally similar to the second embodiment of the manipulator assembly 2088 described above. As will be appreciated from the discussion below, in the fourth embodiment, the handle assembly 4088 shown in FIGS. or can be utilized with a number of different types of manipulator assemblies 4088 that can be configured to be movable to facilitate (this movement is not shown in the fourth embodiment).

With continued reference to FIGS. 32-33, in a fourth embodiment, handle assembly 4096 has a different configuration than handle assembly 96 described in connection with the first embodiment. Specifically, handle assembly 4096 has a more symmetrical shape and is generally configured to rotatably and axially selectively lock to head 4336 of manual interface 4094 (lock not shown). In this embodiment, drive assembly 4082 further includes a differential assembly 4400 interposed between rotary device 4080, connector 4086, and manual interface 4094. As described in more detail below, the differential assembly 4400 is operable in a haptic torque mode 4400H (see FIG. 34A, not shown in detail), allowing a user to engage the handle assembly 4096. , the handle assembly 4096 can drive the tool 4042 through the rotary instrument 4080 to provide tactile torque feedback to the user. When not in use (e.g., when the end effector 4040 is being repositioned), the handle assembly 4096 can be retracted within a dock 4402 formed on the driver 4250 of the drive assembly 4082 (FIG. 32). reference).

In addition to allowing the user to sense haptic torque feedback through the handle assembly 4096 of the manual interface 4094 in haptic torque mode 4400H, the differential assembly 4400 also controls the first embodiment of the end effector 40. provides a function similar to the clutch mechanism 316 described above in connection with. Specifically, the differential assembly 4400 also operates in a first abort mode 4400A (see FIG. 34B, not shown in detail) and a second abort mode 4400B (see FIG. 34C, not shown in detail). It is possible to operate between In a first abort mode 4400A, rotational torque generated by rotating equipment 4080 is transmitted by differential assembly 4400 to connector 4086 to rotate tool 4042 about a second axis A2, while transferring the rotational torque to the manual interface. It is not transmitted to the head 4336 of 4094. In the second abort mode 4400B, the rotational torque generated when a force is applied to the head 4336 of the manual interface 4094 is transmitted by the differential assembly 4400 to the connector 4086, causing the tool 4042 to rotate, but with no rotational torque. It is not transmitted to rotating equipment 4080.

Operation of the differential assembly 4400 in the first abort mode 4400A is accomplished by selectively locking the manual input shaft 4254 to the top cover 4332 of the drive assembly 4082 via the first pin 4404 (see FIG. 34B). , not shown in detail). Similarly, operation of the differential assembly 4400 in the second abort mode 4400B is accomplished by selectively locking the differential assembly 4400 to the top cover 4332 of the drive assembly 4082 via the second pin 4406 ( (see FIG. 34C, not shown in detail). Additionally, operation of the differential assembly 4400 in the haptic torque mode 4400H causes the rotation of the head 4336 about the second axis A2 when the rotary instrument 4080 is driven to rotate the tool 4042 about the second axis A2. To prevent rotation, first pin 4404 and second pin 4406 are selectively removed from top cover 4332 of drive assembly 4082 (see FIG. 34A, not shown in detail) and handle assembly 4096 is removed from the manual interface. This is realized by connecting to the head 4336 of the 4094.

34A-34C, the differential assembly 4400 of the drive assembly 4082 generally includes an interface gear 4408 arranged in rotational communication with the manual interface 4094 and a connector 4086 arranged in rotational communication. a differential case 4412 disposed to be in rotational communication with the rotating device 4080; a pinion shaft 4414 operably attached to the differential case 4412 so as to move simultaneously; and a pinion shaft 4414, respectively. and a pair of pinion gears 4416 disposed to mesh with the interface side gear 4408 and the connector side gear 4410. A differential housing 4418 operably attached to drive assembly 4082 defines a differential chamber 4420 shaped to accommodate at least a portion of differential case 4412 of differential assembly 4400. Each of the components of differential assembly 4400 introduced above will be described in more detail below.

Again, in the fourth embodiment of end effector 4040, gear train 4084 of drive assembly 4082 similarly employs planetary reduction gear set 4286 and bevel gear set 4272. However, in this embodiment, a reduction gear set 4286 is interposed in rotational communication between rotating equipment 4080 (see FIGS. 32-33) and bevel gear set 4272. More specifically, the components of the planetary reduction gear set 4286 are supported within the input body 4374 and generally positioned between the power input shaft 4252 and the carrier shaft 4422 about the first axis A1. Here, input gears 4274 of bevel gear set 4272 are coupled to carrier shaft 4422 for simultaneous rotation about a first axis A1, and output gears 4276 of bevel gear set 4272 are coupled for simultaneous rotation about a second axis A2. Rotatably coupled to differential case 4412.

The differential case 4412 is rotatably supported by a bearing 4262 disposed within a driver 4250, a differential housing 4418, and a top cover 4332, and includes an annular hub 4424 supported by ribs (not shown in detail). and the annular hub 4424 is adapted to receive the second pin 4406 when aligned with a radial cover opening 4428 formed in the top cover 4332 to facilitate operation in the second abort mode 4400B. A plurality of hub apertures 4426 are formed. Manual input shaft 4254 is similarly supported by bearings 4262 located within top cover 4332 and differential case 4412, and is coupled to interface gear 4408 to facilitate operation in first abort mode 4400A. includes an interface aperture 4430 shaped to receive the first pin 4404 when aligned with a transverse cover aperture 4432 formed in the top cover 4332 . Pinion shaft 4414 is held by differential case 4412 and rotatably supports pinion gear 4416, which is arranged to mesh with interface gear 4408 and connector gear 4410, as described above. be done. Here, the connector side gear 4410 is coupled to an intermediate shaft 4256, which in this embodiment is rotatably supported by a bearing 4262 disposed within the differential case 4412.

Differential housing 4418 of differential assembly 4400 defines a differential axis DA, which in the illustrated embodiment is coincident with second axis A2. Here, when in the first abort mode 4400A, rotation of the differential case 4412 relative to the differential housing 4418 is possible. Conversely, when in second stop mode 4400B, rotation of differential case 4412 relative to differential housing 4418 is suppressed. Furthermore, when in the second abort mode 4400B, rotation of both the interface side gear 4408 and the connector side gear 4410 about the differential axis DA is possible. However, when in the first abort mode 4400A, rotation of the connector side gear 4410 about the differential axis DA is possible, but rotation of the interface side gear 4408 about the differential axis DA is suppressed. Further, the pinion shaft 4414 defines a pinion axis PA, and the pinion gear 4416 can rotate about the pinion axis PA in the first abort mode 4400A, the second abort mode 4400B, and the haptic torque mode 4400H. It is possible. In the illustrated embodiment, pinion axis PA is substantially orthogonal to differential axis DA.

As discussed above, in the haptic torque mode 4400H, when the handle assembly 4096 is operating with the handle assembly 4096 connected to the head 4336 of the manual interface 4094, the user may notice that the rotary instrument 4080 moves the tool 4042 to the second axis A2. When driven to rotate about the handle assembly 4096, the handle assembly 4096 can be gripped to prevent rotation of the head 4336 about the second axis A2. When driven by actuator 4166, manual input shaft 4254 and intermediate shaft 4256 each receive the same amount of torque, but can rotate at different speeds.

Thus, the differential assembly 4400 is interposed between the rotary equipment 4080 and the tool 4042 as part of the gear train 4084 such that a user's grip on the handle assembly 4096 causes the manual input shaft 4254 to move into the second axis. If rotation around A2 is prevented, haptic (or "tactile") torque feedback is transmitted to the user's hand. Although handle assembly 4096 does not rotate when grasped, the user nevertheless receives torque feedback substantially equivalent to the amount of torque being applied to tool 4042. Thus, if the driven tool 4042 comprises a rotary drive tool 4048 with a fixture 4050, the user should "feel" a torque in the handle assembly 4096 that is equivalent to the torque in the fixture 4050. This torque feedback advantageously provides a user with a sense of the relative resistance to rotation that fixture 4050 is experiencing when driving fixture 4050 using rotating equipment 4080.

34A-34C, in the fourth embodiment of the end effector 4040, the gear train 4084 further comprises an auxiliary gear set, indicated generally at 4434, which includes an intermediate shaft 4256 and a connector 4086. intervene between The auxiliary gear set 4434 is disposed within an auxiliary housing 4436 that is secured to the driver 4250 by fasteners, and an auxiliary ring gear 4438 is disposed between the auxiliary gear set 4434 and the auxiliary housing 4436. A total of four auxiliary planetary gears 4440 are arranged in meshing engagement with the auxiliary ring gear 4438 and further arranged in meshing engagement with the auxiliary sun gear 4442. The auxiliary planetary gear 4440 is secured to the auxiliary carrier 4444 and the first interface body 4446 via fasteners, and the first interface body 4446 is supported by bearings 4262 disposed within the drive body 4250 and the auxiliary housing 4436, respectively. Ru.

The first interface body 4446 includes a cross recess 4448 defining a rotational stop shaped to engage the bit interface 4128 of the rotational drive tool 4048 shown in FIG. 33, as described in more detail below. . A second interface body 4450 is coupled to the auxiliary sun gear 4442 and supported by a bearing 4262 disposed within the auxiliary carrier 4444 and the first interface body 4446. A peg 4452 is operably attached to the second interface body 4450 and has another rotary engagement shaped to engage the bit interface 4128 of the rotary cutting tool 4044 shown in FIG. 33, as described in more detail below. Define a stop.

In the exemplary embodiment shown herein, peg 4452 defines a first rotational stop RL1 and cross recess 4448 defines a second rotational stop RL2 (see FIG. 34B). Here, the peg 4452 of the first rotational lock RL1 is located closer to the manual interface 4094 than the cross recess 4448 of the second rotational lock RL2. This arrangement corresponds to the configuration of the bit interface 4128 of the rotary drive tool 4048 and rotary cutting tool 4044 shown in FIG. The bit interfaces 4128 shown in FIG. 33 each employ an axial retainer 4130 similar to that described above in connection with the bit interface 128 utilized with the first embodiment of the end effector 40. However, in the fourth embodiment, the rotating retainers 4132 are different from each other and from the first embodiment. More specifically, in the fourth embodiment, the bit interface 4128 of the rotary cutting tool 4044 includes a cutout element 4454 shaped to engage the first rotary stop RL1 (see FIG. 34B). , the bit interface 4128 of the rotary drive tool 4048 includes a key element 4456 configured to engage the second rotary stop RL2 (see FIG. 34C). The key element 4456 has a curved, generally rectangular shape shaped to engage within the cross recess 4448, so that when the rotary drive tool 4048 is secured to the connector 4086, the auxiliary gear set 4434 It simultaneously rotates around the second axis A2 together with the first interface body 4446 (see FIG. 34C). The cutout element 4454 has a shape configured to pass through the cross recess 4448 before engaging either side of the peg 4452, thus allowing the rotary cutting tool 4044 to connect to the second interface when secured to the connector 4086. It simultaneously rotates around the second axis A2 together with the body 4450 (see FIG. 34B).

In the fourth embodiment, the drive assembly 4082 comprises a first rotational stop RL1 and a second rotational stop RL2, but in other embodiments described herein, the drive assembly 4082 includes a first rotational stop RL1 and a second rotational stop RL2. It will be appreciated that it is also possible to use only stop RL1. Additionally, the rotational stop may be similar to, for example, the rotational connector element 308 formed within the retaining shaft 255 of the connector 86 of the drive assembly 82 described above in connection with the first embodiment of the end effector 40. A number of different configurations are possible, including: Other configurations are also contemplated.

Here, in a fourth embodiment, the axial retention of the tool 4042 secured to the connector 4086 is translated simultaneously with the drive assembly 4082 along a trajectory T maintained by the surgical robot 32 (see FIG. 1). is achieved by an axial catch AL configured to releasably secure one of the rotary cutting tool 4044, the rotary drive tool 4048, or another tool 4042. To this end, the axial lock AL is operable between a release configuration ACR (see FIG. 34A) and a locking configuration ACL (see FIGS. 34B-34C). When the axial stop AL is operated in the release configuration ACR shown in FIG. (tool 4042 not shown in FIG. 34A) is permitted along the second axis A2. When the axial lock AL operates in the locking configuration ACL shown in FIGS. 34B-34C, the drive assembly 4082 and the first rotational lock RL1 (see FIG. 34B) or the second rotational lock RL2 ( Relative movement between the tool 4042 and the fixed tool 4042 (see FIG. 34C) is restricted along the second axis A2.

In a fourth embodiment, the axial lock AL is realized by a generally spherical axial connector element 4306 that forms part of the connector 4086 and that The embodiments operate in substantially the same manner. However, the retaining shaft 4255 of the connector 4086 is now supported by a bearing 4262 disposed within the connector body 4300 and the rider body 4458, and the rider body 4458 moves simultaneously with the flange member 4302. When in locked configuration ACL, axial connector element 4306 is supported by bearing 4262 and engages axial retainer 4130 of bit interface 4128 of rotary cutting tool 4044 and rotary drive tool 4048 to Relative movement between element 4306 and axial retainer 4130 along second axis A2 is limited. When the flange member 4302 of the connector 4086 is engaged by the user and moved to the released configuration ACR, movement of the flange member 4302 along the second axis A2 causes the axial connector element 4306 to disengage from the axial retainer 4130. uncoupled and no longer supported by bearing 4262. This arrangement allows the retaining shaft 4255 and the bit interface 4128 of the tool 4042 to rotate simultaneously when secured to the axial stop AL in the lock configuration ACL and when the tool 4042 is removed from the connector 4086. , allowing the holding shaft 4255 to rotate without relying on the first rotational lock RL1 and the second rotational lock RL2.

Again, the axial detent is disposed within a connector element pocket 310 formed within the retaining shaft 255 of the connector 86 of the drive assembly 82 described above in connection with the first embodiment of the end effector 40, for example. It will be appreciated that a number of different configurations are possible, including similar axial connector elements 306. Other configurations are also contemplated.

In the fourth embodiment of the end effector 4040, the auxiliary gear set 4434 effectively acts as a speed increaser between the intermediate shaft 4256 and the second interface body 4450, and thus the first rotational stop RL1 The peg 4452 of is driven at a first drive ratio DR1, whereas the cross recess 4448 of the second rotational lock RL2 is driven at a second drive ratio DR2 and rotates simultaneously with the intermediate shaft 4256. do. Here, the rotation of the intermediate shaft 4256 is transmitted to the auxiliary carrier 4444 via the intermediate coupling 4460. As the auxiliary carrier 4444 rotates, the auxiliary planetary gear 4440 orbits around the second axis A2 while remaining in meshing engagement with the auxiliary ring gear 4438 and the auxiliary sun gear 4442 to rotate about the characteristic axis, thus , the auxiliary sun gear 4442 rotates faster than the auxiliary carrier 4444 about the second axis A2. Thus, as discussed above, different tools 4042 can be driven by drive assembly 4082 at different predetermined drive ratios without necessarily requiring the transmission to "shift" between different gear sets.

As mentioned above, a fifth embodiment of the end effector of surgical system 30 is shown in FIGS. 35-38B. In the following description, structures and components of the fifth embodiment that are the same as or otherwise correspond to structures and components of the first embodiment of the end effector 40 have the same reference numerals incremented by 5000. Has a number. Many of the components and features of the fifth embodiment of end effector 5040 are substantially similar to those of the first embodiment of end effector 40 described above, thereby providing clarity, consistency, and conciseness. For purposes of this, only certain specific differences between the fifth embodiment of end effector 5040 and the first embodiment of end effector 40 are discussed below, and common components and components between these embodiments are discussed below. Only some of the features are discussed herein and illustrated in the drawings.

Accordingly, and without limitation, unless otherwise indicated below, the description of the first embodiment of end effector 40 may be incorporated by reference into the fifth embodiment of end effector 5040. . Similarly, certain components and features of the fifth embodiment of end effector 5040 that are similar to corresponding components and features of the previous embodiments have the same reference numerals for all intervening embodiments. may be referred to in the drawings or otherwise shown as having numbers incremented by 1000 plus 1000 (e.g., in the case of the fifth embodiment, the The components described in relation to the third embodiment should be increased by 2000, the components described in relation to the second embodiment should be increased by 2000, and the components described in relation to the second embodiment should be increased by 2000. should increase by 3000).

35-38B, a fifth embodiment of an end effector 5040 comprising a fixture 5078, a rotary instrument 5080 and its actuator 5166 (schematically shown), and a drive assembly 5082 is shown schematically. has been done. Compared to the first embodiment described above, a fifth embodiment of an end effector 5040 generally employs a different configuration of a handle assembly 5088 and a drive assembly 5082, with a drive forming part of a gear train 5084. The tool 5042 is configured to be secured in a “top loading” manner via the conduit 5462. Each of these components will be described in more detail below.

As best shown in FIGS. 35-36, the fifth embodiment of end effector 5040 includes the same manipulator assembly 5088, grip 5090, and An input operation tool 5092 is provided. Also similar to the second embodiment described above, in the fifth embodiment of the end effector 5040, the rotary device 5080 and drive assembly 5082 are arranged such that the second axis A2 is fixed relative to the first axis A1. It is composed of In other words, again in this embodiment, the driver 5250 of the drive assembly 5082 is not arranged to move relative to the rotating equipment 5080. However, as will be appreciated from the discussion below, the drive assembly 5082 and/or the rotary device 5080 may be arranged relative to each other about the first axis A1 in a manner similar to the first embodiment of the end effector 40. It can also be configured differently, such as to allow positioning. Other configurations are also contemplated.

The drive assembly 5082 of the fifth embodiment of the end effector 5040 includes a drive conduit 5462 to facilitate "top loading" of different types of tools 5042, as described above and in more detail below. , the manual interface 5094 of the fifth embodiment is realized by a bit interface 5128 of the tool 5042 that is fixed to the drive assembly 5082 rather than as part of the drive assembly 5082 itself. However, this configuration is exemplary and, as will be appreciated from the discussion below, the end effector 5040 may still utilize the drive conduit 5462 to drive the tool 5042 while forming part of the drive assembly 5082. A separate manual interface 5094 may also be provided to allow top loading. Other configurations are also contemplated.

36-38B, in a fifth embodiment of an end effector 5040, a drive conduit 5462 of a drive assembly 5082 is supported for rotation about a second axis A2 and a bevel gear set. 5272 is operably attached to output gear 5276 of 5272. Thus, again in this embodiment, the first axis A1 is different from the second axis A2 (see also FIG. 35). More specifically, in this embodiment, the first axis A1 is substantially orthogonal to the second axis A2. However, as will be understood from the eighth embodiment described below, the first axis A1 is parallel to the second axis A2, or even coincides with the second axis A2, etc. It is contemplated that the configuration may also be arranged differently. Other configurations are also contemplated. In the fifth embodiment, the bevel gear set 5272 also provides reduction because the output gear 5276 is different in configuration from the input gear 5274. Therefore, in this embodiment, in addition to converting rotation about the first axis A1 to rotation about the second axis A2, the bevel gear set 5272 also rotates the first axis A1 and the second axis Adjust the rotational torque between A2 and A2.

Similar to the fourth embodiment of the end effector 4040 described above, in the fifth embodiment, the gear train 5084 also employs a planetary reduction gear set 5286 disposed along the first axis A1. Here, a reduction gear set 5286 is interposed in rotational communication between an actuator of rotating equipment 5080 (see FIG. 35, actuator not shown in detail) and drive conduit 5462 of drive assembly 5082, thus , the rotation about the first axis A1 occurs at a different (eg, faster) speed than the rotation of the first rotational stop RL1 about the second axis A2. Furthermore, similar to the third embodiment of the end effector 3040 described above, it facilitates "shifting" between the first gear set GS1 and the second gear set GS2, with correspondingly different drive ratios DR1, A transmission 5372 is provided to drive different types of tools 5042 in DR2. The specific arrangement of each of these components is discussed in more detail below.

The drive assembly 5082 of the fifth embodiment of the end effector 5040 facilitates securing the tool 5042 about the second axis A2 using a first rotational stop RL1 and an axial stop AL. Make it. The first rotational stop RL1 is operably attached to the drive conduit 5462 for simultaneous rotation about the second axis A2. An axial stop AL is provided to releasably secure the tool 5042 for simultaneous translation along a trajectory T maintained by the surgical robot 32 (see FIG. 1) with the drive conduit 5462. a release configuration ACR in which relative movement between assembly 5082 and tool 5042 is possible along second axis A2 (see FIG. 37A, tool 5042 not shown); It is operable with a locking configuration ACL (see FIGS. 37B-37C) in which relative movement is limited along the second axis A2. The configuration of the axial locking tool AL of the fifth embodiment will be described in more detail below.

In a fifth embodiment, the first rotational lock RL1 includes a keyhole formed in a tool body 5466 disposed between an interface end 5468 and a working end 5470 of each tool 5042. It has a generally "square" shape shaped to engage a correspondingly shaped conduit rotating retainer 5464 (see FIG. 36). As will be appreciated from the discussion below, tool body 5466 may be defined by any suitable number of components between interface end 5468 and working end 5470. Similarly, interface end 5468 and/or working end 5470 may be part of tool body 5466 itself, a separate component operably attached to tool body 5466, and/or a configuration releasably attached to tool 5042. It will be appreciated that it may also be defined as an element (eg, a fixture, handle assembly, etc.). Other configurations are also contemplated. Also formed within the tool body 5466 of each tool 5042 is a conduit axial retainer 5472 disposed between an interface end 5468 and a working end 5470, the conduit axial retainer 5472 being in axial engagement in a lock configuration ACL. Engaged by stop AL (see FIGS. 37B-37C). In this embodiment, the working end 5470 of the rotary cutting tool 5044 generally corresponds to the distal cutting end 5044D, and the working end 5470 of the rotary drive tool 5048 generally corresponds to the distal tip of the fixture 5050 secured to the working end 5470. 5050D (see FIG. 36, not shown in fixed state). Further, in this embodiment, the interface end 5468 is generally connected to a rotary cutting tool 5044, a rotary drive tool 5048, or another type of tool 5042 fixed to the drive assembly 5082 for rotation about a second axis A2. Corresponds to bit interface 5128.

Although similar in construction, it will be appreciated that conduit rotation retainer 5464 and conduit axial retainer 5472 of tool body 5466 are different from rotation retainer 5132 and axial retainer 5130 of bit interface 5128. Specifically, in the fifth embodiment, rotary retainer 5132 and axial retainer 5130 of bit interface 5128 are connected to manual interface 5094 for releasably securing to a handle assembly (not shown in this embodiment). Whereas conduit rotation retainer 5464 and conduit axial retainer 5472 of tool body 5466 form a first rotary stop RL1 and an axial lock which in this embodiment effectively act as a connector. The tool 5042 is facilitated to be releasably attached to the drive assembly 5082 through engagement by the tool AL. Furthermore, in the fifth embodiment, the tools 5042 are each configured to engage the same first rotational stop RL1 and the same axial stop AL.

As mentioned above and explained in more detail below, the rotational Tool body 5466 of drive tool 5048 includes a first shaft portion 5474 and tool body 5466 of rotary cutting tool 5044 includes a second shaft portion 5476. The first shaft portion 5474 and the second shaft portion 5476 both extend between the interface end 5468 and the working end 5470 of the tool body 5466 (more specifically, in this embodiment, the conduit axial retainer 5472 between the conduit rotating holder 5464). The first shaft portion 5474 and the second shaft portion 5476 are both shaped and shaped to abut, engage, or otherwise contact at least a portion of the diverter 5394 of the transmission linkage 5392 of the transmission 5372. Placed. As described in more detail below, the diverter 5394 has a generally tubular shape including a stepped outer shape and a cylindrical inner shape disposed along the second axis A2. Because the second shaft portion 5476 is further down toward the working end 5470 than the first shaft portion 5474 (compare FIGS. 37B-37C), the transmission 5372 The abutment between the diverter 5394 and the first shaft portion 5474 facilitates engagement of the first gear set GS1 (see FIG. 37B), whereas the abutment between the diverter 5394 and the second shaft portion The abutment between portion 5476 facilitates engagement of second gear set GS2 (see FIG. 37C).

Referring now to FIGS. 35-37C, the drive conduit 5462 of the drive assembly 5082 defines a drive hole, shown generally at 5478, through which the drive hole 5478 extends toward the tool along the second axis A2. Shaped to receive working end 5470 of 5042. In other words, the drive hole 5478 is larger in size than the drive key 5124 of the rotary drive tool 5048 or the distal cutting end 5044D of the rotary cutting tool 5044. wherein the drive assembly 5082 generally defines a proximal inlet 5480 and an opposing distal outlet 5482, with a drive conduit 5462 interposed in communication between the proximal inlet 5480 and the distal outlet 5482; When the axial lock AL is in the released configuration ACR, the working end 5470 of the tool 5042 is inserted into the proximal inlet 5480 along the second axis A2 and surgically inserted through the drive hole 5478 and out the distal outlet 5482. Allows advancement towards site ST (see Figure 1). As best shown in FIG. 37A, in this embodiment, drive conduit 5462 defines a distal outlet 5482 of drive bore 5478, while proximal inlet 5480 is connected to drive assembly 5082, as described in more detail below. defined by another part of. However, it will be appreciated that other configurations are contemplated, and in some embodiments, the drive conduit 5462 alternatively defines the proximal inlet 5480 or even the entire drive bore 4478.

In a fifth embodiment, at least a portion of the drive bore 5478 disposed adjacent the distal outlet 5482 defines a first rotational stop RL1, the first rotational stop RL1 being axially When the lock AL is in the locked configuration ACL, it is shaped to engage at least a portion of the tool 5042 (here, the conduit rotation retainer 5464) between the interface end 5468 and the working end 5470, and thus the tool Working end 5470 of 5042 is disposed distal to distal outlet 5482 of drive bore 5478. Again, the interface end 5468 of the tool 5042 is positioned proximal to the proximal entrance 5480 of the drive hole 5478 when the axial lock AL is in the locked configuration ACL.

As mentioned above, in the fifth embodiment of the end effector 5040, the gear train 5084 of the drive assembly 5082 connects the actuator of the rotary device 5080 (see FIG. 35, actuator not shown in detail) and the drive conduit 5462. A transmission device 5372 is provided for rotational communication therebetween. Again, the transmission 5372 comprises a first gear set GS1, a second gear set GS2, and a conversion collar 5386, which similarly has a first collar position CP1 (see FIG. 37B) and a second and the collar position CP2 (see FIG. 37C). In the first collar position CP1 shown in FIG. 37B, the translation collar 5386 engages the first gear set GS1 to drive the actuator of the rotary device 5080 at a first drive ratio DR1 (see FIG. 35, the actuator is shown in detail). (not shown) and drive conduit 5462. In the second collar position CP2 shown in FIG. 37C, the translation collar 5386 engages the second gear set GS2 to drive the actuator of the rotary device 5080 at a second drive ratio DR2 (see FIG. 35, the actuator is shown in detail). (not shown) and drive conduit 5462.

As best shown in FIGS. 37A-37C, similar to the third embodiment described above, a fifth embodiment of an end effector 5040 is arranged in mating engagement with a ring gear 5288. Rather, the first set of planetary gears 5290A, the second set of planetary gears 5290B, and the third set of planetary gears 5290C are each configured to meshingly engage the internal teeth 5384 of the conversion collar 5386 of the transmission 5372. will be placed in However, in this embodiment, internal teeth 5384 of conversion collar 5386 are also selected in splined engagement with shaft teeth 5388 of power input shaft 5252 when conversion collar 5386 is in second collar position CP2 (see FIG. 37C). In the third embodiment, shaft teeth 3388 are formed on intermediate shaft 3256. Rotation of power input shaft 5252, facilitated by bearing 5262 disposed within input body 5374, occurs simultaneously with third sun gear 5292C. Again, in this embodiment, external teeth 5390 of conversion collar 5386 are selectively splined to ring gear 5288 when conversion collar 5386 is in first collar position CP1 (see FIGS. 37A-37B). arranged to engage.

In this embodiment, ring gear 5288 is formed on intermediate body 5378 and movement of translation collar 5386 occurs substantially within intermediate body 5378 along first axis A1 (compare FIGS. 37B-37C). sea bream). To this end, the diverter guide 5484 moves simultaneously against and in contact with the diverter collar 5386, and the diverter guide 5484 similarly causes the brace 5396 to pass through the diverter guide 5484 and move the diverter guide 5484 to the first set of pins 5294A. Shaped in such a way that it can provide support to the In this embodiment, the brace 5396 supporting the first set of pins 5294A is formed on the carrier shaft 5422 rather than on the retention shaft 3255 as described in connection with the third embodiment of the end effector 3040. Ru. In this embodiment, a linkage biasing element 5398 is disposed within the intermediate body 5378, and the linkage biasing element 5398 is activated when the axial lock AL is in the released configuration ACL (see FIG. 37A) or when the tool 5042 is not otherwise disposed within drive conduit 5462, abuts conversion collar 5386 to move conversion collar 5386 along first axis A1 toward first collar position CP1.

An input gear 5274 of a bevel gear set 5272 is coupled to a carrier shaft 5422 that is rotated by a bearing 5262 disposed within a carrier support 5486 that is operably attached to a driver 5250 and an intermediate body 5378. It is supported as follows. Carrier shaft 5422 defines a carrier aperture 5488, a portion of diverter guide 5484 is disposed within carrier aperture 5488, and piston element 5490 extends through carrier aperture 5488 along first axis A1. In this embodiment, piston element 5490 forms part of transmission linkage 5392, as does diverter guide 5484. The piston element 5490 is supported by a bearing 5262 disposed within the carrier hole 5488 and the diverter guide 5484 and is moved between the first collar position CP1 and the second collar position CP2 with the diverter guide 5484 and the converter collar 5386. move at the same time.

37A-38B, in response to a corresponding movement of the diverter 5394 along the second axis A2, the piston element 5490 and the diverter guide 5484 are moved simultaneously along the first axis A1. To facilitate this, the transmission linkage 5392 also includes a piston link member 5492 pivotally coupled to the piston element 5490 by a piston pin 5494. Piston link member 5492 is generally disposed within driver 5250 and extends around diverter 5394 in a "wishbone" arrangement. Piston link members 5492 are pivotally connected to respective cam link members 5496 by link pins 5498, and cam link members 5496 are pivotally coupled to pivot fixture 5500 by cam pins 5502. The pivot fixture 5500 is coupled to the driver 5250 by fasteners and is shaped such that the cam pin 5502 is generally located closer to the output gear 5276 than the link pin 5498. Each cam link member 5496 defines a respective cam link surface 5504 (see FIGS. 38A-38B), where the cam link surface 5504 is adapted to engage a corresponding bearing seat surface 5506 defined by a bearing seat 5508. and slides along bearing seat surface 5506. Here, bearing seat 5508 supports bearing 5262 about second axis A2, and bearing 5262 supports switch 5394.

As mentioned above, in the fifth embodiment, the switch 5394 has a stepped outer shape and a generally cylindrical inner shape. More specifically, the diverter 5394 includes a diverter aperture 5510 extending between a proximal diverter end 5512 and a distal diverter end 5514 and extending from the proximal diverter end 5512 to a diverter step 5518. It has a first outer portion 5516 and a second outer portion 5520 extending from the diverter step 5518 to the distal diverter end 5514. Here, the second outer portion 5520 extends through a bearing 5262 disposed on the bearing seat 5508 and the diverter step 5518 is disposed to abut the bearing 5262.

The second outer portion 5520 of the diverter 5394 has a generally cylindrical shape and is received within the second cylindrical region 5522 of the drive hole 5478 disposed above the first rotational stop RL1. It is formed like this. As mentioned above, in this embodiment, drive hole 5478 and first rotational stop RL1 are both defined by output gear 5276. Output gear 5276 is rotatably supported by a bearing 5262 disposed within bottom cover 5524 that is operably attached to driver 5250. When conversion collar 5386 is in either collar position CP1 or CP2 (see FIGS. 38A-38C), at least a portion of second outer portion 5520 of diverter 5394 is in cylindrical area 5522 defined by output gear 5276. It remains located inside. In the illustrated embodiment, the diverter 5394 is not specifically positioned to rotate simultaneously with the output gear 5276, but the diverter hole 5510 allows the tool 5042 to rotate along the second axis A2 in a "top loading" fashion. It will be appreciated that it can be effectively considered an extension of drive hole 5478 since it is similarly shaped to receive a portion. Again, it will be appreciated that in the fifth embodiment of end effector 5040, diverter 5394 can be effectively considered an extension of drive conduit 5462.

The first outer portion 5516 of the diverter 5394 also has a generally cylindrical shape and is shaped to be received within a first cylindrical region 5526 of the retaining shaft 5255, in this embodiment the retaining shaft 5255 is rotatably supported by a bearing 5262 disposed within driver body 5250 and is adapted to engage a conduit axial retainer 5472 formed within tool body 5466 of tool 5042. Works as part of AL. Here, in this embodiment, the first cylindrical region 5526 of the retaining shaft 5255 defines the proximal inlet 5480 of the drive assembly 5082 and, similar to the diverter bore 5510, connects the second axis in a "top-loading" manner. Since it is similarly shaped to receive a portion of tool 5042 along A2, it can effectively be considered an extension of drive hole 5478. Again, it will be appreciated that in the fifth embodiment of the end effector 5040, the retaining shaft 5255 can be effectively considered an extension of the drive conduit 5462.

As shown in FIGS. 37A-37C, in this embodiment, a connector element pocket 5310 is formed within the retention shaft 5255 adjacent the proximal entrance 5480 to accommodate the axial connector element 5306 within the connector element pocket 5310. It is formed like this. Axial connector element 5306 has a substantially spherical configuration and moves radially relative to second axis A2 in response to movement of flange member 5302 along second axis A2 (see FIG. 37A-37C). Here, in this embodiment, the axially ramped surface 5312 is defined by a ramped member 5528 that is formed as a separate component from the flange member 5302 and that ramped member 5528 rotates relative to the flange member 5302 by a bearing 5262. It is supported as follows. The ramp member 5528 moves simultaneously with the flange member 5302, so as the axial ramp surface 5312 moves relative to the retention shaft 5255, the axial connector element 5306 moves radially relative to the second axis A2. In a fifth embodiment of end effector 5040, flange member 5302, ramp member 5528, retention shaft 5255, and axial connector element 5306 cooperate to define an axial stop AL, thereby Connector element 5306 engages conduit axial retainer 5472 of tool 5042 when in locked configuration ACL (see FIGS. 37B-37C) and in released configuration ACR (see FIG. 37A, tool 5042 not shown). At some point, it is disengaged from the conduit axial retainer 5472 away from the second axis A2.

36-38B, as discussed above, conduit rotating retainer 5464 and conduit axial retainer 5472 are connected to both tools 5042 (here, rotary cutting tool 5044 and rotary drive tool 5048). are similarly spaced apart from each other along tool body 5466 corresponding to the relative spacing between axial stop AL and first rotational stop RL1 of drive assembly 5082. . However, the first shaft portion 5474 of the rotary drive tool 5048 and the second shaft portion 5476 of the rotary cutting tool 5044 are connected to the conduit rotation retainer 5464 and the conduit axial retainer along the tool body 5466 of the respective tools 5042. 5472 so that engagement with the proximal diverter end 5512 causes the diverter 5394 to extend differently depending on which tool 5042 is secured to the axial stop AL (FIG. 37A -compare FIG. 37C) to different positions along the second axis A2. In the illustrated embodiment, the second shaft portion 5476 is located closer to the conduit rotating retainer 5464 than the first shaft portion 5474 (see FIG. 36), so that the diverter 5394 When the rotary cutting tool 5044 is secured to the axial stop AL, it moves closer to the first rotary stop RL1 than when it was secured to the axial stop AL (see FIG. 37C and FIG. 37B). (I would like to be compared).

In the fifth embodiment, the transmission device 5372 can also "automatically shift" between gear sets GS1, GS2 based on the configuration of tool 5042 without requiring the user to "manually shift" transmission 5372. be understood. Conversely, movement of the diverter 5394 along the second axis A2 causes the bearing seat 5508 to also move, thereby causing the cam link member 5496 to rotate as the cam link surface 5504 slides over the bearing seat surface 5506. 5500 (compare FIGS. 38A-38B). This movement of cam link member 5496 causes piston link member 5492 to pivot about link pin 5498 coupled to cam link member 5496, thereby causing piston element 5490 to rotate through the connection provided by piston pin 5494. Moves within carrier hole 5488 of carrier shaft 5422. As a result, piston element 5490 moves simultaneously with diverter guide 5484 and conversion collar 5386 between first collar position CP1 and second collar position CP2 (compare FIGS. 38B-38C).

As discussed above, the drive conduit 5462 of the drive assembly 5082 is configured to releasably secure different types of tools 5042 in a "top loading" manner. This configuration allows a particular type of surgical procedure and/or a particular type of joint movement to be performed based on the amount of joint motion available to the base 34 and/or the surgical site ST via the robotic arm 36 (see FIG. 1), among other things. Significant advantages over tool 5042 are obtained. More specifically, "top loading" refers to substantially loading the end effector so as to provide sufficient clearance relative to the surgical site ST for removal of one tool and/or subsequent installation of another tool. In scenarios where it is undesirable or impractical to move or otherwise change the position of the end effector, or as a result of the technique utilized by the surgeon, it may be sufficient for one type of tool, but not for a different type of tool. Advantageously, it can be utilized in scenarios where the robotic arm 36 is articulated relative to the base 34 in a manner that is undesirable or impractical for the robot. In other words, it is contemplated that certain types of tools will not require as much overall movement of the robot arm 36 as in a "bottom-loading" style to facilitate a "top-loading" style of installation; It is contemplated that the equation may provide an improved opportunity to utilize the range of articulation of the robotic arm 36 relative to the base 34 and the surgical site ST than would normally be available in a "bottom-loading" equation. .

The above examples are illustrative and not limiting, and the "bottom-loading" equation described in connection with the first, second, third, and fourth embodiments may be applied to different tools sequentially utilized during a surgical procedure. It will be appreciated that they can also be used together and, in certain circumstances, may be preferable to a "top-loading" style. Similarly, in certain scenarios for both end effectors configured to secure the tool in a "bottom-loading" fashion and end effectors configured to secure the tool in a "top-loading" fashion, It will be appreciated that movement of the end effector along the trajectory T to facilitate changes in can be made, or may even be desirable. Nevertheless, an undesirable amount of movement along the trajectory T is typically required to provide sufficient clearance to completely remove one tool 5042 and install another tool 5042 in a "bottom-loading" manner. The "top-loading" style provided by the fifth embodiment of the end effector 5040 is particularly advantageous if the lengths of the different tools 5042 utilized sequentially are different, as is required.

As mentioned above, a sixth embodiment of the end effector of surgical system 30 is shown in FIGS. 39A-44B. In the following description, structures and components of the sixth embodiment that are the same or otherwise correspond to structures and components of the first embodiment of end effector 40 have the same reference numerals incremented by 6000. Has a number. Many of the components and features of the sixth embodiment of end effector 6040 are substantially similar to those of the first embodiment of end effector 40 described above, thereby providing clarity, consistency, and conciseness. For purposes of this, only certain specific differences between the sixth embodiment of end effector 6040 and the first embodiment of end effector 40 are discussed below, and common components and components between these embodiments are discussed below. Only some of the features are discussed herein and illustrated in the drawings.

Accordingly, and without limitation, unless otherwise indicated below, the description of the first embodiment of end effector 40 may be incorporated by reference into the sixth embodiment of end effector 6040. . Similarly, certain components and features of the sixth embodiment of end effector 6040 that are similar to corresponding components and features of previous embodiments have the same reference numerals for all intervening embodiments. may be referred to in the drawings or otherwise shown as having numbers incremented by 1000 plus 1000 (e.g., in the case of the sixth embodiment, the The components described in connection with the fourth embodiment should increase by 2000, the components described in connection with the third embodiment should increase by 2000, and the components described in connection with the third embodiment should increase by 2000. should increase by 3000 and the components described in connection with the second embodiment should increase by 4000).

39A-44B, a sixth embodiment of an end effector 6040 comprising a fixture 6078, a rotary instrument 6080 and its actuator 6166 (schematically shown), and a drive assembly 6082 is shown schematically. has been done. Compared to the first embodiment described above, a sixth embodiment of an end effector 6040 generally employs a different configuration of a handle assembly 6088 and a drive assembly 6082, and in a manner similar to the fifth embodiment. , is configured to secure the tool 6042 in a “top loading” manner via the drive conduit 6462. Each of these components will be described in more detail below.

As best shown in FIGS. 39A-40, in the sixth embodiment, drive assembly 6082 is similarly configured to be releasably attached to rotating equipment 6080 via coupler 6230, and thus the drive assembly By positioning 6082 differently about the first axis A1, the second axis A2 can be moved relative to the first axis A1. In a sixth embodiment, manipulator assembly 6088 uses a grip 6090 and input manipulator 6092 that are structurally similar to the third embodiment of manipulator assembly 3088 described above. Again, the frame 6134 of the manipulator assembly 6088 includes a first frame body 6362 and a second frame body 6364. The first frame body 6362 similarly connects between a plurality of manipulator assembly positions, including a first manipulator assembly position P1 (see FIGS. 39A-39B) and a second manipulator assembly position P2 (see FIG. 39C). They are coupled to retainer 6136 for simultaneous movement. Furthermore, the second frame body 6364 similarly moves the first frame between a plurality of grip positions including a first grip position G1 (see FIG. 39A) and a second grip position G2 (see FIGS. 39B-39C). A grip 6090 and an input manipulator 6092 are supported for movement relative to the main body 6362. However, in this embodiment, the second frame body 6364 moves between the first grip position G1 and the second grip position G2, as opposed to the translational movement described and illustrated in connection with the third embodiment. The first frame body 6362 is arranged to pivot between the first frame body 6362 and the first frame body 6362.

When in the first grip position G1 shown in FIG. 39A, at least a portion of the second frame body 6364 restricts access to the manual interface 6094, in this embodiment manual As in the embodiment, this is accomplished by the bit interface 6128 of the tool 6042 being secured to the drive conduit 6462 in a "top loading" manner. Further, as described in more detail below, when in first grip position G1, input manipulator 6092 similarly drives rotary instrument 6080 into drive conduit 6462 when engaged by a user. The fixed tool 6042 is arranged to rotate around the second axis A2. However, when in the second grip position G2 shown in FIG. 39B, the second frame body 6364 facilitates receiving applied force from the user to rotate the tool 6042 about the second axis A2. The manual interface 6094 is spaced apart from the manual interface 6094 so that the The second frame body 6364 is also arranged to move simultaneously with the first frame body 6362 between the plurality of manipulator assembly positions P1, P2 without depending on the movement between the plurality of grip positions G1, G2. (Compare Figures 39A-39C).

In the sixth embodiment of the end effector 6040, the second frame body 6364 is configured to pivot between a first grip position G1 (see FIG. 39A) and a second grip position G2 (see FIG. 39B). arranged, the pivoting movement taking place along a pivot axis VA arranged substantially perpendicular to both the first axis A1 and the second axis A2. To this end, as best shown in FIG. 41, a pivot pin 6530 pivotally couples the first frame body 6362 and the second frame body 6364 together and is operably attached to the first frame body 6362. A tensioner 6532 extends into a tensioner slot 6534 formed in the second frame body 6364 to limit movement of the second frame body 6364 relative to the first frame body 6362. Here, the tensioner slot 6534 has an arcuate shape that effectively defines a first grip position G1 and a second grip position G2, and has an adjustable amount of rotation about the pivot axis VA. the first grip position G1 and the second grip position G2, or between the first grip position G1 and the second grip position G2, to provide resistance or otherwise. It can also be utilized to "lock" the second frame body 6364 to the frame body 6362.

As shown in FIG. 41, in a sixth embodiment, a linkage 6178 of a manipulator assembly 6088 is connected between a first input location I1 and a second input location I2 using a cable arrangement shown generally at 6536. (first input position I1 shown in FIG. 41) in response to corresponding movement of input manipulator 6092 of FIG. To this end, cable arrangement 6536 includes a flexible conduit 6538 extending between a pair of tensioner assemblies 6540 coupled to first frame body 6362 and second frame body 6364, respectively. A wire 6542 (schematically shown in FIG. 41) is coupled to input manipulator 6092 and piston 6182 and extends through tensioner assembly 6540 and flexible conduit 6538, thus providing a corresponding response as a result of movement of input manipulator 6092. The piston 6182 also moves, and the piston 6182 engages the fork guide 6188 of the rotary device 6080 to move the fork guide 6188 (see FIG. 40). This configuration facilitates pivoting of the second frame body 6364 relative to the first frame body 6362 while allowing the second frame body 6364 to move from the first grip position G1 (see FIG. 39A) to the second grip position G2 (see FIG. 39B). ), or any other grip position between the first grip position G1 and the second grip position G2, the input operating tool 6092 can be moved between the first input position I1 and the second input position I2. Be sure to be able to move between.

40 and 42B, a total of three different exemplary types of tools 6042 are shown in connection with the sixth embodiment of an end effector 6040, each of which includes the end effector described above. As in the fifth embodiment of 5040, it is configured to "top load" into drive conduit 6462 of drive assembly 6082 along second axis A2. More specifically, FIG. 40 shows a dissection tool 6544 and one type of rotary drive tool 6048 for use in driving a fixture 6050, and FIG. 42B schematically shows an alignment tool 6546. . As described in more detail below, the rotary drive tool 6048 has structural differences compared to the previously described embodiments, but nevertheless extends through the drive conduit 6462 and through the rotary instrument 6080. The drive assembly 6082 is configured to be releasably attached to the first rotational stop RL1 and the axial stop AL of the drive assembly 6082 in a "top-loading" manner so as to be driven about the axis A2 of the drive assembly 6082 about the axis A2 of the drive assembly 6082. In the illustrated embodiment, dissection tool 6544 and alignment tool 6546 are configured to be received within drive conduit 6462 also along second axis A2, while first rotational stop RL1 or axis It is not configured to be attached to the directional lock AL. Here, dissection tool 6544 and alignment tool 6546 can be inserted into drive conduit 6462 along second axis A2 and positioned relative to surgical site ST by surgical robot 32 (see FIG. 1). Because it can be implemented as a "passive" tool 6042, it is not driven by rotary equipment 6080 as an "active" tool 6042, such as a rotary drive tool 6048. Other types of "active" and/or "passive" tools 6042 other than those introduced above are also contemplated by this disclosure.

In the representative example shown in connection with the sixth embodiment, "passive" tools 6042, such as dissecting tool 6544 and alignment tool 6546, move about second axis A2 without relying on drive conduit 6462. It is free to rotate and translate away from the drive conduit 6462 along the second axis A2. In other words, in this embodiment, the "passive" tool 6042 does not engage the first rotational stop RL1 or the axial stop AL, but is nevertheless driven along the second axis A2. It can be inserted into conduit 6462 and removed from drive conduit 6462 without requiring user interaction with axial lock AL. In contrast to the "passive" tool 6042, the "active" tool 6042 engages both the first rotational stop RL1 and the axial stop AL and drives the drive conduit around the second axis A2. 6462 and requires user interaction with axial lock AL to facilitate removal from drive conduit 6462.

The "passive" tool 6042 shown in connection with the sixth embodiment is a tool that moves the drive conduit 6462 along the second axis A2 without engaging the first rotational stop RL1 or the axial stop AL. However, certain types of "passive" tools 6042 are configured to not engage the first rotational stop RL1 but to engage the axial stop AL. It is contemplated that it may also be possible to do so, thus allowing free rotation about the second axis A2, but that translation along the second axis A2 should be restrained.

As best shown in FIGS. 40 and 43B, the dissection tool 6544 generally includes a dissection shaft 6548 and a dissection cannula 6550. Dissection shaft 6548 is shaped to extend through dissection cannula 6550 between a knob 6552 located at interface end 6468 and a tip 6554 located at working end 6470. The dissection cannula 6550 includes a guide body 6556 extending from a stop element 6558 to a toothed end 6560 with a first tapered step 6562 adjacent the stop element 6558 and a second tapered step 6562 adjacent the toothed end 6560. It has a generally cylindrical shape indicated by a tapered step 6564. Here, the guide body 6556 of the dissection cannula 6550 acts as a tool body 6466 until the abutment between the stop element 6558 and the drive assembly 6082 limits further translational movement along the second axis A2. can be inserted into the drive conduit 6462 along axis A2 of the drive conduit 6462. Dissection cannula 6550 is free to rotate within drive conduit 6462. The dissection shaft 6548 can be inserted into the dissection cannula 6550 along the second axis A2 until the distal end 6554 of the dissection shaft 6548 extends beyond the toothed end 6560 of the guide body 6556. Again, dissection shaft 6548 is free to rotate within dissection cannula 6550 about second axis A2. Knob 6552 of dissection shaft 6548 is shaped and positioned to be grasped by a user, such as to facilitate advancement or retraction of dissection shaft 6548 through dissection cannula 6550. Surgical robot 32 (see FIG. 1), such as in various types of "haptic" or "free" modes that allow articulation of robotic arm 36 in response to applied forces acting on end effector 6040. A knob 6552 can be used to facilitate moving or otherwise positioning the end effector 6040 relative to the base 34 of the surgical procedure. It is also contemplated that movement relative to the region ST can be enabled (eg, along a trajectory T or based on various types of virtual boundaries). Accordingly, when the surgical robot 32 (see FIG. 1) operates in one or more "haptic" or "free" modes, the user can grasp the knob 6552 and apply a force in a particular direction to End effector 6040 can be moved.

Referring now to FIG. 42B, alignment tool 6546 is schematically shown as being disposed within drive conduit 6462 of drive assembly 6082. In this illustrative embodiment, the guide body 6556 of the alignment tool 6546 is similar to the tool body 6466 and is distal to the drive conduit 6462 from the stop element 6558 when the stop element 6558 abuts the drive assembly 6082. along the second axis A2 to a module end 6566 located at. However, as will be appreciated from the discussion below, module end 6566 may be arranged differently, such as to be placed within drive hole 6478, without departing from the scope of this disclosure. can.

In the illustrated embodiment, a light source, indicated generally at 6568, is coupled to guide body 6556 adjacent module end 6566 of alignment tool 6546. The light source 6568 is substantially aligned with the second axis A2 (and thus the trajectory T) when the alignment tool 6546 is inserted into the drive conduit 6462 of the drive assembly 6082 along the second axis A2. It is configured to emit light L towards the surgical site ST along the optical path LP. wherein an activation button 6570 coupled to the stop element 6558 is placed in electrical communication with the light source 6568 to facilitate selectively emitting light L when actuated by a user; Can be done. A battery or another type of power source (not shown) can be placed within guide body 6556 to power light source 6568. In some embodiments, light source 6568 can be configured as a laser diode. In some embodiments, depending on the specific configuration of the light source 6568, the emitted light L can be visualized as a "dot" aligned along a trajectory T projected onto the surgical site ST. It can also be visualized as a "beam" aligned along the optical path LP (and thus the trajectory T). It will be appreciated that light source 6568 may be configured to emit light L at any suitable wavelength sufficient to be visualized in any suitable manner. As a non-limiting example, the light L can be visualized directly (e.g., within the visible spectrum) and/or indirectly (e.g., by a camera feed presented on a display screen). can be converted into

Furthermore, it will be appreciated that a variety of different types of light sources 6568 may be utilized in addition to or in place of the light sources 6568 described herein that are shown throughout the figures. By way of non-limiting example, a light source may be provided to direct or otherwise emit light L generally toward the surgical site ST, such as for general illumination purposes. In some embodiments, the light source 6568 is provided in U.S. Patent Application Publication No. 2013/0053648 (A1) entitled "Surgical Tool for Selectively Illuminating a Surgical Volume," the disclosure of which is incorporated herein by reference in its entirety. It can be configured in the same way as that described in No. It will be appreciated that other types and configurations of fixtures 50 and their associated installations are also contemplated by this disclosure. Additionally, it will be appreciated that other types of optical devices (eg, cameras) may also be used in some embodiments. Other configurations are also contemplated.

Alignment tool 6546 is configured to be removably attached to drive conduit 6462 of drive assembly 6082 so that light source 6568 and/or entire alignment tool 6546 can be disposed of for recycling or reprocessing after the surgical procedure. It can be configured as a "disposable" component. Alternatively, light source 6568 and/or alignment tool 6546 can be configured as "reusable" components that are sterilized after the surgical procedure. Other configurations are also contemplated.

In the exemplary embodiment shown in FIG. 42A, light source 6568 is not configured to be removably attached to drive conduit 6462 of drive assembly 6082. Conversely, in this embodiment, light source 6568 and activation button 6570 are coupled to second frame body 6364 of handle assembly 6088 for simultaneous movement relative to first frame body 6362. Now, when the second frame body 6364 is placed in the first grip position G1 shown in FIG. can be emitted towards the surgical site ST along a light path LP aligned with T). This configuration allows the tool 6042 to remain cannulated along the second axis A2 (e.g., to receive a guidewire GW, not shown in this embodiment) when the tool 6042 is removed from the drive conduit 6462. The light source 6568 can also be utilized when the light source 6568 is positioned within the drive conduit 6462. Further, similar to that described above in connection with FIG. 42B, the light source 6568 can be of other types, configurations, etc., and can be used for a variety of different optical devices (e.g., cameras, lights for general illumination, etc.) can be provided. Other configurations are also contemplated.

As shown in FIGS. 43A-43C, in a sixth embodiment, the gear train 6084 of the drive assembly 6082 similarly uses a bevel gear set 6272 to direct rotation about a first axis A1 to a second axis A2. Convert to rotation around . To this end, input gear 6274 is coupled to carrier shaft 6422 for simultaneous rotation about a first axis A1, and output gear 6276 is coupled to drive conduit 6462 for simultaneous rotation about a second axis A2. The drive conduit 6462 is rotatably supported by a bearing 6262 disposed within the drive body 6250 . As in the fifth embodiment of the end effector 5040 described above, the bevel gear set 6272 also provides a reduction between the input gear 6274 and the output gear 6276, and a planetary type gear set disposed along the first axis A1. A reduction gear set 6286 is utilized. Here, rotation of power input shaft 6252 facilitated by bearing 6262 located within input body 6374 occurs simultaneously with third sun gear 6292C. The carrier shaft 6422 is supported for rotation about a first axis A1 by a bearing 6262 disposed within the intermediate body 6378 and is operably attached to the first set of pins 6294A. A first set of planetary gears 6290A, a second set of planetary gears 6290B, and a third set of planetary gears 6290C are each arranged in meshing engagement with a ring gear 6288, and in this embodiment, a ring gear 6288 is formed within the input body 6374.

40 and 43A-44B, in the sixth embodiment of the end effector 6040, the first rotational stop RL1 is located within the drive conduit 6462 adjacent to the proximal entrance 6480 of the drive bore 6478. This is realized as a spline hole defined by a drive spline 6572 formed as a spline hole. Drive spline 6572 has a corresponding transition gear 6576 configured to be releasably attached to axial lock AL to facilitate retention of "active" tool 6042, as described in more detail below. Releasably engages outer transition spline 6574. Transition gear 6576 also includes an inner transition spline 6578 that releasably engages a corresponding tool spline 6580 formed in tool body 6466 of “active” tool 6042. The drive spline 6572 formed within the drive conduit 6462 has a generally frustoconical shape that tapers inwardly toward the distal outlet 6482 with respect to the second axis A2. The outer transition spline 6574 of the transition gear 6576 is shaped complementary to the drive spline 6572 such that it is positioned in mating engagement with the drive spline 6572 (see FIGS. 43C-43D). The inner transition spline 6578 also has a generally frustoconical shape, but tapers inward toward the proximal inlet 6480 with respect to the second axis A2 rather than the distal outlet 6482 like the drive spline 6572. Again, the tool spline 6580 formed in the tool body 6466 of the "active" tool 6042 is positioned relative to the inner transition spline 6578 of the transition gear 6576 such that it is positioned in mating engagement with the inner transition spline 6578. Complementarily shaped (see FIGS. 43C-43D).

Drive spline 6572 is positioned proximal to drive shelf 6582 formed within drive conduit 6462. The drive shelf 6582 has a flat ring-shaped shape facing away from the distal outlet 6482 and is secured via an axial lock AL, as described in more detail below. Shaped and positioned to engage an abutment surface 6584 formed on tool body 6466 of tool 6042. This configuration limits how far the tool body 6466 can be advanced into the drive hole 6478 so that the tool body 6466 is in the second axis when the axial lock AL is in the locking configuration ACL. Helps ensure proper positioning with respect to drive conduit 6462 along A2.

As best shown in FIGS. 43C-43D, in the sixth embodiment, the tool body 6466 of the "active" tool 6042 also includes an engagement flange 6586 disposed between the abutment surface 6584 and the tool spline 6580. Equipped with Engagement flange 6586 defines a flange surface 6588 facing away from abutment surface 6584. Here, flange surface 6588 is shaped and positioned to engage transition surface 6590 of transition gear 6576. The transition gear 6576 also includes a handling portion 6592 extending away from the transition surface 6590 to the handling surface 6594 and defines a transition hole 6596 extending between the handling surface 6594 and the transition surface 6590 along the second axis A2; Inner transition spline 6578 is formed within or otherwise defined by transition hole 6596. A transition notch 6598 is disposed between the handling portion 6592 and the outer transition spline 6574 of the transition gear 6576, and the transition notch 6598 is arranged such that the axial catch AL is in the locking configuration ACL and the drive conduit about the second axis A2. When tool 6042 is fixed for rotation at the same time as 6462 , relative movement relative to both drive conduit 6462 and tool body 6466 of "active" tool 6042 and between drive conduit 6462 and tool body 6466 of "active" tool 6042 Provided to facilitate limiting relative movement.

In the sixth embodiment, rather than being formed as part of the tool 6042, the transition notch 6598 is formed through engagement with a pair of axial connector elements 6306 that form part of a locking assembly, generally designated 6600. and serves as a conduit axial retainer 6472. As best shown in FIGS. 43A and 43D-44B, lock assembly 6600 includes a lock housing 6602 operably attached to drive conduit 6462 for simultaneous rotation about second axis A2. The lock housing 6602 is similarly shaped to substantially define a proximal entrance 6480 of the drive bore 6478 and to receive the working end 6470 of the tool 6042 along the second axis A2 through the proximal entrance 6480. The lock housing 6602 includes a slider slot 6604 within which a slider element 6606 is supported for movement in a direction substantially perpendicular to the second axis A2. Axial connector element 6306 is operably attached to slider element 6606 for simultaneous movement relative to lock housing 6602 and cooperates to define axial lock AL through engagement with transition notch 6598. do.

As best shown in FIGS. 44A-44B, the slider element 6606 defines a guide slot 6608 within which a guide pin 6610 operably attached to the lock housing 6602 is disposed. Here, the cooperation between the guide slot 6608 and the guide pin 6610 results in a first slider element position SL1 (see FIG. 44B) associated with the release configuration ACR and a second slider element position associated with the lock configuration ACL. A slider element 6606 is retained within slider slot 6604 for movement relative to second axis A2 between SL2 (see FIG. 44A). Axial connector element 6306 coupled to slider element 6606 is positioned closer to second axis A2 when in second slider element position SL2 than when in first slider element position SL1. A slider biasing element 6612 disposed within slider slot 6604 and interposed between slider element 6606 and lock housing 6602 moves slider element 6606 toward second slider element position SL2. A slider engagement button 6614 is provided integrally with slider element 6606 and is arranged to move from second slider element position SL2 to first slider element position SL1 when engaged by a user. . The slider engagement button 6614 is positioned generally perpendicular to a stop surface 6616 defined by the lock housing 6602, which is the portion of the drive assembly 6082 that abuts the stop element 6558 of the "passive" tool 6042. (See Figure 43B).

43C-44B, working end 6470 is inserted into proximal entrance 6480 of drive bore 6478 to facilitate attachment of "active" tool 6042 to drive conduit 6462 of drive assembly 6082. , can be advanced along second axis A2 and out of distal outlet 6482, and in the sixth embodiment, distal outlet 6482 is operably attached to drive conduit 6462 adjacent bottom cover 6524. defined by a lower cap 6618. The tool body 6466 can now be advanced into the drive hole 6478 until the abutment surface 6584 of the tool 6042 engages the drive shelf 6582 of the drive conduit 6462. The user then grasps the handling portion 6592 of the transition gear 6576, passes the interface end 6468 of the tool 6042 through the transition hole 6596, and advances the transition gear 6576 along the second axis A2 so that the transition surface 6590 can be moved toward and abutted against the flange surface 6588 of the tool body 6466. Alternatively, the user can "install" the transition gear 6576 onto the tool 6042 to matingly engage the inner transition spline 6578 with the tool spline 6580 and then move the working end 6470 into the proximal entrance 6480 of the drive hole 6478. It can be inserted inside. Drive spline 6572 engages and meshes with outer transition spline 6574 and inner transition spline 6578 engages and meshes with tool spline 6580 to define first rotational stop RL1 and, thus, drive conduit 6462. , transition gear 6576, and tool 6042 rotate simultaneously about second axis A2. Further, when the transition surface 6590 of the transition gear 6576 abuts the engagement flange 6586 of the tool 6042, the axial lock AL engages the axial connector element 6306 held by the slider element 6606 and within the transition gear 6576. movement into the locking configuration ACL defined by engagement between the formed transition notch 6598 to permit relative movement along the second axis A2 between the tool 6042, the transition gear 6576, and the drive conduit 6462. To prevent.

As mentioned above, a seventh embodiment of the end effector of surgical system 30 is shown in FIGS. 45-48B. In the following description, structures and components of the seventh embodiment that are the same as or otherwise correspond to structures and components of the first embodiment of end effector 40 have the same reference numerals incremented by 7000. Has a number. Many of the components and features of the seventh embodiment of end effector 7040 are substantially similar to those of the first embodiment of end effector 40 described above, thereby providing clarity, consistency, and conciseness. For purposes of this, only certain specific differences between the seventh embodiment of end effector 7040 and the first embodiment of end effector 40 are discussed below, and common components and components between these embodiments are discussed below. Only some of the features are discussed herein and illustrated in the drawings.

Accordingly, and without limitation, unless otherwise indicated below, the description of the first embodiment of end effector 40 may be incorporated by reference into the seventh embodiment of end effector 7040. . Similarly, certain components and features of the seventh embodiment of end effector 7040 that are similar to corresponding components and features of the previous embodiments have the same reference numerals for all intervening embodiments. may be referred to in the drawings or otherwise shown as having numbers incremented by 1000 plus 1000 (e.g., in the case of the seventh embodiment, relative to the sixth embodiment). The components described in connection with the fifth embodiment should increase by 2000, the components described in connection with the fourth embodiment should increase by 2000, and the components described in connection with the fourth embodiment should increase by 2000. should increase by 3000, the components described in connection with the third embodiment should increase by 4000, and the components described in connection with the second embodiment should increase by 5000. ).

45-48B, a seventh embodiment of an end effector 7040 comprising a fixture 7078, a rotary instrument 7080 and its actuator 7166 (schematically shown), and a drive assembly 7082 is shown schematically. has been done. Compared to the first embodiment described above, a seventh embodiment of an end effector 7040 generally uses the same type of control assembly 7088, the drive assembly 7082 of which is described in more detail below. , configured to secure the tool 7042 in a "top loading" manner via the drive conduit 7462 in a manner similar to the fifth and sixth embodiments.

In a seventh embodiment, two exemplary types of tools 7042 are shown in FIG. 46, including a rotary cutting tool 7044 and a scalpel tool 7620 in different configurations. Here, the rotary cutting tool 7044 is realized as an "active" tool 7042 adapted to rotate simultaneously with the drive conduit 7462 about the second axis A2, and the scalpel tool 7620 is realized as a "passive" tool 7042. Ru. Like the dissection tool 6544 described above in connection with the sixth embodiment of the end effector 6040, the illustrated scalpel tool 7620 and rotary cutting tool 7044 similarly utilize a knob 7552 located at the interface end 7468 of the tool body 7466. . However, as shown in FIG. 47C, the knob 7552 of the rotary cutting tool 7044 is arranged to rotate independently relative to the tool body 7466 via a bearing 7262 operably attached to the interface end 7468. . Here, in this embodiment, the illustrated rotary cutting tool 7044 does not have any type of manual interface and is driven while being held by the first rotary stop RL1 and axial stop AL of the drive assembly 7082. rotation about second axis A2 through engagement with conduit 7462, each of which will be described in more detail below. In other words, in this embodiment, the rotary cutting tool 7044 is not configured to be "manually" rotated by the user about the second axis A2, but instead is here gripped by the user. The rotating device 7080 is utilized to rotate the working end 7470 about the second axis A2 without transmitting the rotation back to the user's hand. However, it will be appreciated that other configurations are contemplated and one or more tools 7042 may also include a manual interface similar to that shown and described in connection with the previous embodiments.

47A-48B, in the seventh embodiment of the end effector 7040, the drive assembly 7082 similarly utilizes the drive conduit 7462 to direct the torque generated by the rotating equipment 7080 to the second facilitates driving the "top loading" of the tool 7042 about the axis A2 of the tool 7042. Again, gear train 7084 includes a planetary type reduction gear set 7286 interposed between power input shaft 7252 and carrier shaft 7422, and input gear 7274 and output gear 7276 have different configurations. Additional reduction is provided by bevel gear set 7272. In a seventh embodiment, an input gear 7274 is coupled to a carrier shaft 7422, whereas an output gear 7276 is coupled to a tapered conduit 7622 that forms part of a collet mechanism 7624, which includes: It is configured to facilitate axial and rotational retention of the "active" tool 7042 and serves as a first rotational stop RL1 and an axial stop AL. Here, the tapered conduit 7622 is supported for rotation about a second axis A2 via a bearing 7262 disposed within the drive body 7250 of the drive assembly 7082 and is simultaneously connected to the lower cap 7618 and the upper cap 7626. 2 (see FIGS. 47A to 47C). The tapered conduit 7622 has a tapered aperture 7628 that has a generally frustoconical shape with increasing radius relative to the second axis A2 in a direction away from the proximal inlet 7480 and toward the distal outlet 7482. . A correspondingly shaped collet 7630 is disposed within the tapered bore 7628, and in this embodiment, the collet 7630 generally includes a resilient collet body that defines a drive conduit 7462 and extends from a proximal collet end 7634 to a distal collet end 7636. It has 7632.

As best shown in FIG. 47A, the resilient collet body 7632 is realized as a single unitary component having an "ER collet" configuration and defines a collet aperture 7638 having a generally cylindrical shape; , defining a drive hole 7478. As will be described in more detail below, the resilient collet body 7632 is oriented at least partially radially toward the second axis A2 to facilitate retention of the tool 7042 through engagement with the tool body 7466. Constructed to flex inward. The collet 7630 also has a proximal collet portion 7640 shaped to be received within the tapered bore 7628 of the tapered conduit 7622 and a second axis A2 in a direction away from the proximal inlet 7480 and toward the distal outlet 7482. and a collet notch 7644 disposed between the proximal collet portion 7640 and the distal collet portion 7642.

Collet notch 7644 receives collet retainer 7646 of collet knob 7648 that is positioned to be engaged by a user. Here, the collet knob 7648 forms part of a collet tensioner 7650 of a collet mechanism 7624 coupled to a collet 7630 and has a first tensioner position TP1 (see FIGS. 47B and 48B) and a second tensioner position TP2 (see FIGS. 47A and FIG. 48A). A first tensioner position TP1 is associated with a release configuration ACR of the axial lock AL that allows relative movement between the tool 7042 and the collet 7630, and a second tensioner position TP2 is associated with a release configuration ACR of the axial lock AL that allows relative movement between the tool 7042 and the collet 7630. associated with a locking configuration ACL of the axial lock AL, in which the relative movement between the

As best shown in FIGS. 47A and 48A-48B, the collet knob 7648 of the collet tensioner 7650 is connected via a pair of knob guides 7652 (e.g., fasteners) that extend through a knob slot 7654 formed within the collet knob 7648. , operably attached to the lower cap 7618 of the drive assembly 7082. Knob slot 7654 has a generally helical shape with a first knob slot end 7656 and a second knob slot end 7658 that are connected to knob guide 7652. , thereby defining a first tensioner position TP1 and a second tensioner position TP2, respectively, of collet tensioner 7650. A knob biasing element 7660 is interposed between collet knob 7648 and lower cap 7618 to move collet tensioner 7650 toward a first tensioner position TP1 (see FIGS. 47B and 48B). With this configuration, the knob guide 7652 acts as a "detent" into the first knob slot end 7656 and the second knob slot end 7658 until the user rotates the collet knob 7648 relative to the bottom cap 7618; It is possible to remain within the first knob slot end 7656 and the second knob slot end 7658. In other words, the user rotates the collet knob 7648 to move the axial lock AL between the released configuration ACR (see FIGS. 47B and 48B) and the locked configuration ACL (see FIGS. 47A and 48A). Can be done.

Because of the configuration of knob slot 7654 described above, rotation of collet knob 7648 via a force applied by the user results in collet knob 7648 also being translated along second axis A2. Furthermore, due to the engagement between the collet retainer 7646 of the collet knob 7648 and the collet notch 7644 of the collet 7630, rotation of the collet knob 7648 results in the collet 7630 also being aligned with the second axis A2 within the tapered bore 7628 of the tapered conduit 7622. Translate along. The user now engages the collet knob 7648 to move the collet tensioner 7650 from the first tensioner position TP1 (see FIGS. 47B and 48B) to the second tensioner position TP2 (see FIGS. 47A, 47C, and 48A). ), collet 7630 moves toward proximal inlet 7480 and radially inwardly toward second axis A2 via engagement between proximal collet portion 7640 and tapered bore 7628. compressed into For an "active" tool 7042, when the tool body 7466 of the tool 7042 is placed within the drive hole 7478 defined by the collet hole 7638, this compression forces at least a portion of the resilient collet body 7632 against the tool body 7466. and “squeezes” tool 7042 onto drive conduit 7462, thereby causing movement of both first rotational lock RL1 and axial lock AL. For a "passive" tool, such as scalpel tool 7620, collet tensioner 7650 is utilized in a first tensioner position TP1 and is not moved to a second tensioner position TP2.

In a seventh embodiment of the end effector 7040, both "active" and "passive" tools 7042 can be inserted into the drive conduit 7462 along the second axis A2 in a "top-loading" manner and the drive It can be removed from conduit 7462. To this end, when the collet tensioner 7650 is in the first tensioner position TP1 (see FIG. 47B), the working end 7470 is inserted into the proximal inlet 7480 and the collet hole 7638 (in this embodiment (defining drive bore 7478) and out the distal outlet 7482 (defined in this embodiment by collet knob 7648). As shown in FIG. 48C, certain types of tools 7042 can include a stop fitting 7662 at an interface end 7468, where the stop fitting 7662 is defined by the stop surface 7616 (in this embodiment, by the top cap 7626). The tool 7042 is shaped and arranged to abut the tool 7042 (see FIG. 1), thereby preventing further advancement of the tool 7042 along the second axis A2 into the drive hole 7478. However, it will be appreciated that other configurations are contemplated and the position of the tool 7042 relative to the drive conduit 7462 along the second axis A2 may be limited in other ways. When the tool 7042 is in the "active" configuration, the collet tensioner 7650 is moved from the first tensioner position TP1 to the 2 tensioner position TP2. However, if the tool is in a "passive" configuration, the collet tensioner 7650 can remain in the first tensioner position TP1 as described above.

As mentioned above, an eighth embodiment of an end effector of surgical system 30 is shown in FIGS. 49A-63F. In the following description, structures and components of the eighth embodiment that are the same or otherwise correspond to structures and components of the first embodiment of end effector 40 have the same reference numerals incremented by 8000. Has a number. Many of the components and features of the eighth embodiment of end effector 8040 are substantially similar to those of the first embodiment of end effector 40 described above, thereby providing clarity, consistency, and conciseness. For purposes of this, only certain specific differences between the eighth embodiment of end effector 8040 and the first embodiment of end effector 40 are discussed below, and common components and components between these embodiments are discussed below. Only some of the features are discussed herein and illustrated in the drawings.

Accordingly, and without limitation, unless otherwise indicated below, the description of the first embodiment of end effector 40 may be incorporated by reference into the eighth embodiment of end effector 8040. . Similarly, certain components and features of the eighth embodiment of end effector 8040 that are similar to corresponding components and features of previous embodiments have the same reference numerals for all intervening embodiments. may be referred to in the drawings or otherwise shown as having numbers incremented by 1000 plus 1000 (e.g., in the case of the eighth embodiment, relative to the seventh embodiment). The components described in connection with the sixth embodiment should increase by 2000, the components described in connection with the fifth embodiment should increase by 2000, and the components described in connection with the fifth embodiment should increase by 2000. should increase by 3000, the components described in connection with the fourth embodiment should increase by 4000, and the components described in connection with the third embodiment should increase by 5000. (and the components described in connection with the second embodiment should increase by 6000).

49A-63F, an eighth embodiment of an end effector 8040 is schematically illustrated including a fixture 8078, a rotary instrument 8080 and its actuator 8166, and a drive assembly 8082. When compared to the other embodiments described above, the eighth embodiment of end effector 8040 is configured such that rotating instrument 8080 and drive assembly 8082 are integrally formed. In other words, in the eighth embodiment, drive assembly 8082 is not positioned to move relative to actuator 8166. Additionally, as described in more detail below, the eighth embodiment of the end effector 8040 also has a first axis A1 that is different from a second axis A2 (e.g., The first axis A1 is arranged to coincide with the second axis A2, rather than being orthogonal). More specifically, the eighth embodiment provides rotation of the tool 8042 with a first axis A1 also defined by the rotational torque generated by the actuator 8166 and a second axis A2 also fixed to the drive assembly 8082. is similar to the previous embodiment in that it is defined by , but in this embodiment the axes A1, A2 are the same. Furthermore, when compared to the other embodiments described above, the eighth embodiment of the end effector 8040 has a driving mechanism similar to the fifth, sixth, and seventh embodiments, as described in more detail below. Different configurations of manipulator assembly 8088, drive assembly 8082, first rotational lock RL1 and second rotational lock RL2 cooperate to secure tool 8042 in a "top loading" manner via conduit 8462 , as well as an axial lock AL.

49A-49B, as discussed above, in the eighth embodiment of the end effector 8040, the drive assembly 8082 and the actuator 8166 of the rotary instrument 8080 are integrally formed so that the instrument housing 8168 and the drive body 8250 is realized by the same component (hereinafter referred to as driver 8250). The fixture 8078 is operably attached to or otherwise formed as part of the driver 8250 and is releasable to the coupling 38 of the robotic arm 36 of the surgical robot 32 (see FIG. 1). Similarly adapted to be attached to. In addition to the mount 8078, a handle assembly 8088 and retention mechanism 8664 are also operably attached to the driver 8250. Further, in the eighth embodiment of the end effector 8040, the driver 8250 houses an actuator subassembly 8666, a reduction gear set 8286, and a drive conduit 8462 (see FIG. 50), and the actuator subassembly 8666 and actuator 8166 thereof, or otherwise define rotating device 8080 and actuator 8166 thereof. As described in more detail below in connection with FIGS. 56A-59B, retention mechanism 8664 includes a protective cover 8350 to facilitate retention of tool 8042 to drive conduit 8462 along second axis A2. It is configured as follows.

As best shown in FIG. 50, actuator subassembly 8666 generally includes a rotor subassembly 8668 and a stator subassembly 8670. Rotor subassembly 8668 is configured to be received distally into stator subassembly 8670 and is retained within driver 8250 via bottom cover 8524. A stator subassembly 8670 is received proximally into the driver body 8250 and is retained via an actuator end plate 8672, which is positioned for threaded engagement with the driver body 8250 (see also FIG. 57). Please refer). Stator subassembly 8670 includes a stator 8674 (schematically shown) and a motor sensor 8676, which is used to effect commutation of actuator 8166, among other things, in the exemplary embodiments shown herein. Here, actuator 8166 is implemented as an inrunner brushless DC electric motor with rotor 8678 formed as part of rotor assembly 8668.

More specifically, as best shown in FIG. 51, rotor assembly 8668 includes rotor 8678, reduction gear set 8286, and drive conduit 8462. Here, the rotor 8678 has a generally tubular shape and is located on a perch 8680 formed in the carrier shaft 8422, so that in this embodiment the carrier shaft 8422, which also has a generally tubular shape, Extending through rotor 8678. An actuator ring clamp 8682 secures the rotor 8678 to the carrier shaft 8422 via a threaded engagement, which is supported by a bearing 8262 disposed within the drive body 8250 and thus locks the rotor 8678 of the reduction gear set 8286. and carrier shaft 8422 simultaneously rotate about second axis A2 (also, in this embodiment, first axis A1). In the eighth embodiment, the carrier shaft 8422 also defines a second carrier 8298B of a reduction gear set 8286 and a drive for the second rotational stop RL2 and drive assembly 8082, as described in more detail below. Both proximal entrances 8480 of holes 8478 are defined.

51 and 57, drive conduit 8462 extends along second axis A2 between proximal conduit end 8684 and distal conduit end 8686, and includes End 8686 forms a portion of drive hole 8478 of drive assembly 8082 . The first rotational stop RL1 is realized as a first notch 8688 formed in the proximal conduit end 8684 of the drive conduit 8462 and rotates about a second axis A2, as described in more detail below. The particular tool 8042 is configured to rotatably secure the particular tool 8042 to do so. A first sun gear 8292A of reduction gear set 8286 is secured at distal conduit end 8686 via one or more retaining pins 8690 (see FIGS. 59A-59B) for simultaneous rotation with drive conduit 8462. Ru. The first sun gear 8292A is arranged in meshing engagement with a first set of planet gears 8290A, which is also arranged in meshing engagement with a ring gear 8288. . A first set of planet gears 8290A is supported by a first carrier 8298A, and the first carrier 8298A is coupled to a second sun gear 8292B, such as a second carrier 8298B defined by a carrier shaft 8422. Drive conduit 8462 extends through second sun gear 8292B. Here, a first set of planetary gears 8290A is supported by a bearing 8262, which is supported by a first set of pins 8294A coupled to a first carrier 8298A.

A second sun gear 8292B is secured to the first carrier 8298A via one or more retaining pins 8690 (see FIG. 57) and is positioned in meshing engagement with a second set of planet gears 8290B. , a second set of planetary gears 8290B is also positioned in mating engagement with ring gear 8288 and supported by a second carrier 8298B defined by carrier shaft 8422. More specifically, in this embodiment, carrier shaft 8422 extends between distal carrier end 8692 and proximal carrier end 8694, and second carrier 8298B of reduction gear set 8286 extends between distal carrier end 8692 and proximal carrier end 8694. placed adjacent to. Here, a second set of planetary gears 8290B is supported by a bearing 8262, which is supported by a second set of pins 8294B coupled to a second carrier 8298B. As described in more detail below, the second rotational stop RL2 is different from the first rotational stop RL1 as a second notch 8696 formed in the proximal carrier end 8694 of the carrier shaft 8422. realized and configured to rotatably fix the particular tool 8042 for rotation about the second axis A2, independent of the rotation of the first rotational lock RL1.

In an eighth embodiment of the end effector 8040, the reduction gear set 8286 is defined by a second notch 8696 formed in the carrier shaft 8422 (which rotates simultaneously with the rotor 8678 of the actuator 8166, as described above). A torque reduction (and speed A two-stage planetary configuration is used that provides an increase in In other words, in the eighth embodiment, drive conduit 8462 (and first rotational stop RL1) rotates at a faster speed than actuator 8166 (and second rotational stop RL2). Furthermore, in the eighth embodiment, the rotation of the second rotational stop RL2 about the second axis A2 is coupled to the first axis A1 (in this embodiment, coincident with the second axis A2) of the actuator 8166. occurs in a 1:1 ratio for rotations around Relative rotation between drive conduit 8462 and carrier shaft 8422 is facilitated via a bearing 8262 supported on first carrier 8298A and within carrier shaft 8422 (see FIG. 57). As described in more detail below, the tool 8042 may engage a first rotational stop RL1 to rotate simultaneously with the drive conduit 8462 or a second rotational stop RL2 to rotate the actuator. Whether rotating simultaneously with 8166 or not, when tool 8042 is secured to end effector 8040, at least a portion of tool body 8466 extends through drive conduit 8462 along second axis A2.

As discussed above, the eighth embodiment of the end effector 8040 includes a differently configured manipulator assembly 8088 and an input manipulator 8092 that, when engaged by a user, generates a The tool 8042 is arranged to facilitate driving the tool 8042 through a rotational torque applied to the tool 8042. As best shown in FIG. 50, the manipulator assembly 8088 is generally operably attached to the first manipulator subassembly 8698 and the first manipulator subassembly 8698, such as through one or more fasteners. and a second operation subassembly 8700 (see FIG. 57). More specifically, the first manipulation subassembly 8698 includes a top mounting plate 8702 and a grip mount 8704 to which the second manipulation subassembly 8698 is attached. As described in more detail below, a retention mechanism 8664 is operably mounted adjacent to an upper mounting plate 8702, which also supports a pair of indicator housings, shown generally at 8706. Additionally, grip fixture 8704 includes a protective lock subassembly 8708 configured to releasably secure protective cover 8350 of retention mechanism 8664, as described in more detail below.

In addition to the actuator end plate 8672, a circuit board 8710 and an intermediate mounting plate 8712 are also interposed between the stator subassembly 8670 and the upper mounting plate 8702 of the first operating subassembly 8698. Here, actuator end plate 8672 is secured to actuator end plate 8672 via threaded engagement and circuit board 8710 is secured to actuator end plate 8672 via one or more fasteners. Similarly, intermediate mounting plate 8712 is secured to driver 8250 via one or more fasteners, and upper mounting plate 8702 is secured to intermediate mounting plate 8712 via one or more fasteners. Intermediate mounting plate 8712 supports various seals 8270 and fasteners (eg, bolts, circlips, etc.) and generally facilitates ease of assembly of end effector 8040.

In the illustrated embodiment, the stator subassembly 8670 includes an indexing tab 8714 that extends away from the bottom cover 8524 into a plate opening 8716 formed in the actuator end plate 8672 and into the circuit board 8710. Extending through both substrate openings 8718 formed. This configuration helps facilitate alignment of stator assembly 8670 with respect to driver 8250 and motor sensor 8676 supported within driver 8250, which in the illustrated embodiment is attached to circuit board 8710. and a board controller 8720 (shown schematically, electrical connections not shown). Here, substrate controller 8720 communicates with other components of surgical system 30, facilitates commutation and/or operation of actuator 8166, and various functions of end effector 8040, as described in more detail below. It can be utilized to control inputs (eg, additional sensors) and/or outputs (eg, indicators).

52-54, the second manipulation subassembly 8700 is operably attached to the grip attachment 8704 of the first manipulation subassembly 8698, such as by one or more fasteners. The second manipulation subassembly 8700 generally includes a grip 8090, an input manipulation 8092, and a manipulation biasing element 8212 located within the input manipulation 8092 (see FIG. 54). Here, in the eighth embodiment of the end effector 8040, movement of the input operating tool 8092 between the first input position I1 and the second input position I2 is supported within an operation sensor keeper 8724 fixed to the grip 8090. The input operating tool 8092 is held against the grip 8090 via a pin and slot arrangement (not shown in detail).

An operational sensor 8722 is disposed in electrical communication with a board controller 8720 mounted on a circuit board 8710 (see FIG. 50, electrical connections not shown) and a first operational sensor coupled to an input control 8092. In response to movement of the transmitter 8726 and the second operating transmitter 8728, they simultaneously move between the first input position I1 and the second input position I2 (see FIG. 54). To this end, when the input operating tool 8092 is in the first input position I1, the first operating transmitter 8726 is arranged adjacent to the operating sensor 8722, and when in the second input position I2, the first operating transmitter 8726 is arranged adjacent to the operating sensor 8722. Two operations 8728 are arranged adjacent to the operation sensor 8722. The operational sensor keeper 8724 also supports an input button 8730, which is also positioned in electrical communication with the board controller 8720 (see FIG. 50, electrical connections not shown) and can be engaged by the user. It is arranged so that Input button 8730 is located within a cover opening 8732 formed in a grip cover 8734 secured to grip 8090 via a fastener and, when engaged by the user, facilitates additional control of surgical system 30. It is arranged so that It will be appreciated that the input button 8730 can also be configured to facilitate controlling multiple different aspects of the end effector 8040 (eg, switching to haptic mode). Other configurations are also contemplated.

In addition to input controls 8092 and input buttons 8730, second control subassembly 8700 also pivots relative to grip 8090 between left and right switch positions (not shown in detail) through engagement by the user. An input switch 8736 is supported by a switch shaft 8738 to do so. Here, a switch sensor 8740 is located within grip 8090 that is placed in electrical communication with substrate controller 8720 (see FIG. 50, electrical connections not shown). Switch sensor 8740 simultaneously moves relative to grip 8090 in response to movement of switch emitter 8742 coupled to input switch 8736 . In the illustrated embodiment, a switch detent arrangement, shown generally at 8744, is provided to maintain the input switch 8736 in one of the left and right switch positions during disengagement from the user. Although not shown in detail, a switch emitter 8742 is disposed adjacent to the switch sensor 8740 in one of the left and right switch positions maintained by the switch detent arrangement 8744 and in the other of the left and right switch positions. The board controller 8720 is spaced apart from the switch sensor 8740 at a position such that the board controller 8720 can distinguish between left and right switch positions. Like input button 8730 described above, movement of input switch 8736 can be utilized to facilitate additional control of surgical system 30. As a non-limiting example, movement of the input switch 8736 between the left and right switch positions described above may, for example, rotate the tool 8042 about the second axis A2 in a clockwise direction and a counterclockwise direction, respectively. operation of the actuator 8166 in the "forward" and "reverse" directions. Other configurations are also contemplated.

55-57, the first manipulation subassembly 8698 is configured to facilitate releasably securing the protective cover 8350 of the retention mechanism 8664 in the first protective position U1; In the eighth embodiment, the first protected position U1 is such that the tool 8042 is rotatable by one of the first rotational stop RL1 and the second rotational stop RL2, and the axial stop Ensure that it is also held axially by the AL. Here, as will be understood from the description of the retention mechanism 8664 that follows, the first protection position U1 also defines the operation of the axial stop AL in the locking configuration ACL and the first protection position U1 of the end effector 2040 described above. 2 embodiment, facilitates access to a manual interface 8094.

The protective locking subassembly 8708 of the first operating subassembly 8698 selectively restricts movement of the protective cover 8350 of the retention mechanism 8664 relative to the grip fixture 8704 to maintain movement of the axial stop AL in the locking configuration ACL. to be suppressed. To this end, as best shown in FIG. A protection lever 8746 is provided so as to be pivoted relative to the protection lever 8746. A protective lever 8746 is disposed between a pair of washers 8214 supported on a lever fastener shank 8748 and includes a lever pawl 8752 that engages a lever biasing element, as described in more detail below. The pawl stop member 8754 of the retention mechanism 8664 is positioned to engage the pawl stop member 8754 of the retaining mechanism 8664 via the pawl stop member 8756 . The keeper fixture 8750 also supports a lever sensor 8758 that is responsive to movement of a lever transmitter 8760 coupled to the guard lever 8746 for simultaneous movement between a locked configuration ACL and a released configuration ACR. The protective lock subassembly 8708 also includes an upper vertical stop 8762 coupled to the keeper fixture 8750 and lower vertical stops 8764 and lateral stops 8766, each coupled to the grip fixture 8704. As described in more detail below, in lock configuration ACL, pawl stop member 8754 is positioned to engage between lever pawl 8752 and lateral stop 8766, and upper vertical stop 8762 and lower vertical stop 8764 are Each engages an upper vertical member 8768 and a lower vertical member 8770, each coupled to a retention mechanism 8664 (see FIG. 56C).

With continued reference to FIG. 55, the protective lock subassembly 8708 of the first operating subassembly 8698 also includes a protective sensor 8772 supported within the grip fixture 8704 adjacent to the lower vertical stop 8764. The protection sensor 8772 is responsive to changes in the position of a protection emitter 8774 (see FIGS. 56B and 56D) coupled to the retention mechanism 8664. The protection sensor 8772 and the lever sensor 8758 are both placed in electrical communication with the board controller 8720 (see FIG. 50, electrical connections not shown) and are connected to the lock configuration ACL, as described in more detail below. It cooperates to determine the movement of the axial lock AL between the release configuration ACR. Additionally, the indicator housings 8706 coupled to the top mounting plate 8702 of the first operating subassembly 8698 each include a pair of indicator modules 8776 (e.g., light emitting diodes), which likewise include a board controller 8720 and a pair of indicator modules 8776 (e.g., light emitting diodes). The end effector 8040 is arranged in electrical communication (see FIG. 50, electrical connections not shown) and responsive to various corresponding or otherwise predetermined configurations or operating parameters associated with the end effector 8040. can be used to provide visual feedback to the user by changing color, status, brightness, etc. As a non-limiting example, the indicator module 8776 can emit a red light when the axial lock AL is in the released configuration ACR and a green light when the axial lock AL is in the locked configuration ACL. Can emit light. Other configurations are also contemplated.

between various electrical components operably attached to first operating subassembly 8698 and second operating subassembly 8700 and a board controller 8720 and/or other components mounted on circuit board 8710; It will be appreciated that telecommunications for can be facilitated in a number of different ways, including, but not limited to, wired connections, wireless communications, and the like. Additionally, in the eighth embodiment of end effector 8040, handle assembly 8088 is generally not arranged to move relative to driver 8250, although in some embodiments all or a portion of handle assembly 8088 It will be appreciated that the can also be configured to move or otherwise be selectively positioned by the user. As a non-limiting example, all or a portion of grip 8090 may be movable (e.g., rotated) such that one or more sensors, buttons, etc. move simultaneously with grip 8090 relative to circuit board 8710 and/or driver 8250. possible). In such embodiments, U.S. Provisional Patent Application No. 62/678, filed May 31, 2018, entitled "Rotating Switch Sensor for a Robotic System," the disclosure of which is incorporated herein by reference in its entirety. , 838. Other configurations are also contemplated.

Referring now to FIG. 49B, two types of tools are configured to be "top-loaded" attached to the drive conduit 8462 of the end effector 8040: a rotary cutting tool 8044, and a rotary drive tool 8048 with a fixture 8050. 8042 is shown. Here, the tools 8042 each include a bearing element 8778 formed on the tool body 8466 between an interface end 8468 and a working end 8470. Bearing element 8778 is shaped and positioned to engage bearing 8262 that defines a portion of drive bore 8478 defined adjacent distal outlet 8482 (see FIG. 59B). This configuration helps facilitate alignment of tool 8042 to rotate about second axis A2. Each tool 8042 also includes a proximal key body 8780 located at the interface end 8468 of the tool body 8466. The proximal key bodies 8780 for each of the exemplary tools 8042 shown in FIG. 49B are different, but each define a proximal key surface 8782 that is substantially orthogonal to the second axis A2. A proximal key element 8784 having a cylindrical outer shape extends from the proximal key face 8782 in a direction away from the working end 8470 of the tool body 8466. As described in more detail below, proximal keying surface 8782 and proximal keying element 8784 cooperate with retention mechanism 8664 to facilitate movement of axial lock AL.

In an eighth embodiment, tools 8042 of the type shown each have a different configuration of conduit rotation retainer 8464 interposed between proximal key element 8784 and bearing element 8778. More specifically, the rotary cutting tool 8044 includes a first seat element 8786 having a first notch element 8788 and a first seat flange 8790 defining a first seat surface 8792, and the rotary cutting tool 8044 8048 includes a second seat element 8794 having a second cutout element 8796 and a second seat flange 8798 defining a second seat surface 8800. The first seat element 8786 is shaped and arranged to be disposed within the drive conduit 8462, the first cutout element 8788 is disposed within the first cutout 8688, and the first seat surface 8792 is shaped and arranged to be disposed within the drive conduit 8462; Abutting proximal conduit end 8684 of conduit 8462 defines a first rotational stop RL1 (see FIGS. 58A-58D). The second seat element 8794 is shaped and arranged to be disposed within the carrier shaft 8422, the second cutout element 8796 is disposed within the second cutout 8696, and the second seat surface 8800 is shaped and arranged to be disposed within the carrier shaft 8422. Abutting the proximal carrier end 8694 of the shaft 8422 defines a second rotational stop RL2 (see FIGS. 63A-63E, not shown in detail).

56A-57, as described above, in the eighth embodiment of the end effector 8040, the retention mechanism 8664 defines an axial stop AL and includes a protective cover 8350. Here, the protective cover 8350 similarly moves from the first protective position U1 (see FIGS. 56A-56D) to the second protective position U1 (see FIGS. It is movable to the protection position U2 (see FIG. 57). Further, the axial lock AL engages and disengages the protective lock subassembly 8708 between the locking configuration ACL (see FIGS. 56A-56B) and the release configuration ACR (see FIGS. 56C-56D). It can be moved to uncoupled. Here, in the eighth embodiment of the end effector 8040, before moving the axial lock AL into the locking configuration ACL, the protective cover 8350 must be placed in the first protective position U1, thereby simultaneously Relative movement between fixed tool 8042 and drive conduit 8462 is limited via mechanism 8664 and relative movement between protective cover 8350 and driver 8250 is also limited via protective lock subassembly 8708. To this end, as best shown in FIGS. 56B and 57, the protector 8352 of the protective cover 8350 is provided with a knob guide slot 8802, and the knob retainer 8804 coupled to the protective knob 8806 is inserted into the knob guide slot. Move along 8802. Knob retainer 8804 supports bearings 8262 and rotates into knob guide slot 8802 as protection knob 8806 is rotated to facilitate movement of axial lock AL, as described in more detail below. Proceed along.

The protective knob 8806 is prevented from being removed from the protector 8352 through one or more fasteners (e.g., rings, circlips, etc.) and a knob keeper 8808 that engages and protects the protective knob 8806. A protective knob biasing element 8810 is supported that is positioned to move the knob 8806 away from the protector 8352. This configuration engages the protective knob 8806 to move the axial lock AL from the locked configuration ACL (see FIGS. 56A-56B and 58D) to the released configuration ACR (see FIGS. 56C-56D and 58C). tactile feedback is provided to the user when the user rotates the protective knob 8806 and moves it from the released configuration ACR to the locked configuration ACL as the knob retainer 8804 moves along the knob guide slot 8802. When the protective knob biasing element 8810 is compressed.

56A-58D, the retention mechanism 8664 also includes a key hub 8812 and a key collar 8814 operably attached to the protective knob 8806. A bearing 8262 rotatably supports the key hub 8812 for rotation relative to the protection knob 8806, and when the axial lock AL moves between the release configuration ACR and the lock configuration ACL, the key thrust bearing 8816 Helps prevent binding between key hub 8812 and protection knob 8806. Key collar 8814 includes a key collar slot 8818 within which a key pin 8820 coupled to key hub 8812 is movably positioned. This configuration retains the key collar 8814 while facilitating restricting movement of the key collar 8814 relative to the key hub 8812. A key collar biasing element 8822 interposed between key hub 8812 and key collar 8814 moves key collar 8814 generally away from key hub 8812. When one of the tools 8042 is inserted through the drive conduit 8462 and the protective cover 8350 is moved to the first protective position U1 shown in FIG. is spaced from the proximal key element 8784 of. Here, the key collar 8814 is positioned closer to the proximal key element 8784 than the key hub 8812, and subsequent movement of the axial lock AL toward the lock configuration ACL causes the protection knob 8806 to rotate. , the key collar 8814 abuts the proximal key surface 8782 of the tool body 8466 and in the lock configuration ACL, the key collar biasing element 8822 is compressed. As shown in FIG. 58D, the key hub 8812 is shaped to receive the proximal key element 8784 of the tool 8042 when in the locking configuration ACL, with portions of both the key hub 8812 and key collar 8814 is placed so that it is in contact with the This configuration helps guide proximal key element 8784 into key hub 8812, which helps facilitate alignment of tool 8042 about second axis A2.

Key collar 8814 and key hub 8812 each have a generally cylindrical inner shape positioned adjacent proximal inlet 8480 and in communication with drive hole 8478 when protective cover 8350 is in first protective position U1. . Additionally, the protective cover 8350 includes a generally cylindrical knob opening 8824 positioned to cooperate with the inner shape of the key collar 8814 and key hub 8812. This configuration provides the user with the ability to access the manual interface 8094 through the knob opening 8824, and in the eighth embodiment of the end effector 8040, the knob opening 8824 is shown below in connection with FIGS. 60-62B. It is implemented as part of a rotary drive tool 8048, as described in more detail.

As best shown in FIG. 56C, a lower vertical member 8770 is coupled to the protector 8352 and a lower vertical stop coupled to the grip fixture 8704 when the protective cover 8350 is in the first protected position U1. It comes into contact with 8764. Upper vertical member 8768, pawl stop member 8754, and protection transmitter 8774 (see FIG. 56D) are each coupled to protection knob 8806 for simultaneous movement relative to protection 8352. When the protection knob 8806 is rotated to move the axial catch AL from the released configuration ACR shown in FIGS. 56C-56D to the locked configuration ACL shown in FIGS. 56A-56B, the pawl stop 8754 first lever pawl 8752 , thereby pivoting protection lever 8746 , after which rotation of protection knob 8806 continues to cause pawl stop member 8754 to abut lateral stop 8766 . Here, in the locking configuration ACL shown in FIGS. 56A-56B, the lever biasing element 8756 urges the protective lever 8746 against the pawl stop member 8754, which is also positioned to abut the lateral stop 8766. be done. Again, top vertical member 8768 abuts top vertical stop 8762. Thus, in the locked configuration ACL, movement of the protection knob 8806 relative to the protection body 8352 and grip attachment 8704 is inhibited until the user engages the protection lever 8746 to release the pawl stop 8754. As discussed above, the protection sensor 8772 coupled to the grip fixture 8704 is responsive to movement of the protection transmitter 8774 coupled to the protection knob 8806, and thus the board controller 8720 controls the locking configuration ACL and the release configuration ACR. The movement of the axial lock AL between can be determined. Similarly, a lever sensor 8758 coupled to the grip fixture 8704 is responsive to movement of a lever emitter 8760 coupled to the protection lever 8746 and, therefore, the board controller 8720 can determine movement of the protection lever 8746. Can be done.

60-62B, as discussed above, the illustrated rotary drive tool 8048 is adapted to be releasably attached to an eighth embodiment of an end effector 8040 in a "top loading" manner; An eighth embodiment of an end effector 8040 uses a different configuration of a locking subassembly 8810 to lock the fixture 8050 when compared to the rotary drive tool 48 described above in connection with the first embodiment of the end effector 40. configured to be releasably attached to. Here in an eighth embodiment, as best shown in FIG. and a bearing element 8778 is disposed between the external thread 8120 and the profile 8108. Drive shaft 8104 is similarly arranged to be rotatably supported within support tube 8106 and extends between drive key 8124 adjacent working end 8470 and hexagonal portion 8826 adjacent interface end 8468. . A locking element detent 8828 formed within the hexagonal portion 8826 locks the drive shaft locking element 8830 to facilitate simultaneous rotation of the drive shaft 8104 and support tube 8106 under certain conditions described in more detail below. shaped to receive.

A second sheet element 8794 is formed as a separate component from support tube 8106 and is positioned adjacent contour body 8108. Here, a pair of fasteners secures the second sheet element 8794 to the carriage 8832 for simultaneous translation and rotation about the second axis A2. The carriage 8832 generally includes a carriage ring 8834 that is generally secured to the second seat element 8794, a carriage bridge 8836, and extends between and is integral with the carriage ring 8834 and the carriage bridge 8836. a pair of carriage arms 8838. Carriage bridge 8836 defines a first carriage surface 8840 and an opposing second carriage surface 8842. Here, proximal key body 8780 and proximal key element 8784 are arranged such that proximal key surface 8782 is spaced from and substantially parallel to first carriage surface 8840. Extending from first carriage surface 8840. A carriage pilot 8844 extends from the second carriage surface 8842 toward the carriage ring 8834 and includes a pair of locking element pockets 8846 shaped to support a drive shaft locking element 8830. Carriage pilot 8844 also includes a hexagonal hole 8848 that extends through carriage pilot 8844 (from proximal key element 8784) and is shaped to receive hexagonal portion 8826 of drive shaft 8104. Again in the eighth embodiment, the hexagonal hole 8848 also serves as a manual interface 8094 and is accessible along the second axis A2 through the knob opening 8824 (see FIG. 58D). Although not shown in this embodiment, it will be appreciated that the manual interface 8094 can be engaged via a correspondingly shaped handle assembly to rotate the carriage 8832 about the second axis A2.

With continued reference to FIGS. 60-62B, the locking subassembly 8810 of the rotary drive tool 8048 also includes a locking body 8114 disposed between the profiled body 8108 and the carriage 8832 and When the assembly 8810 operates in the power transfer lock configuration DL (see FIGS. 61A and 62A), it can rotate simultaneously with the support tube 8106 via the spline engagement 8112 with the profile 8108. However, the support tube 8106 can rotate independently of the drive shaft 8104 when the lock subassembly 8810 operates in the power transmission unlock configuration DU, and in the power transmission unlock configuration DU, the support tube 8106 locks with the profile body 8108. Spline engagement 8112 with body 8114 is discontinued (see FIGS. 61B and 62B). Here, a locking body biasing element 8850 supported by a locking seat 8852 formed on the locking body 8114 is disposed within the contoured body 8108 to move the locking subassembly 8810 toward the power transmission unlocking configuration DU.

Lock body 8114 is also shaped to receive a relief pocket 8854 located within lock seat 8852 axially adjacent spline engagement 8112 (see FIGS. 61A-62B) and a carriage bridge 8836 of carriage 8832. Therefore, relative rotation between the carriage 8832 and the lock body 8114 is suppressed in both the power transmission lock configuration DL and the power transmission lock release configuration DU. A relief pocket 8854 is formed within the lock body 8114 and is positioned to accommodate the drive shaft locking element 8830 when the lock subassembly 8810 is in the power transfer lock configuration DL (see FIG. 62A). This configuration allows drive shaft 8104 to be advanced relative to carriage 8832 along second axis A2, such as to facilitate installation of fixture 8050 prior to installation of tool 8042 into drive conduit 8462. becomes possible. Conversely, when in the power transmission unlocked configuration DU (see FIG. 62B), the drive shaft locking element 8830 is spaced from the relief pocket 8854 to restrain axial movement of the drive shaft 8104 relative to the carriage 8832; Generally located within lock seat 8852. This configuration also allows the support tube 8106 to be moved relative to the drive shaft 8104, such as by disengaging the male threads 8120 of the support tube 8106 from the female threads 8122 of the fixture 8050, thereby facilitating removal of the fixture 8050. It becomes possible to rotate the

To selectively maintain the lock subassembly 8110 in a power transfer lock configuration DL or a power transfer unlock configuration DU, the lock subassembly 8810 also includes a carriage lock lever 8858 located within a stepped region 8860 of the lock body 8114. Be prepared. Carriage lock lever 8858 is pivotally supported relative to lock body 8114 via pin 8119, biased via spring 8118, and has a first lever surface 8862 and an opposite second lever surface 8864. Define. Here, the first lever surface 8862 abuts the first carriage surface 8840 in the power transfer lock release configuration DU (see FIG. 61B), and the second lever surface 8864 abuts the first carriage surface 8840 in the power transfer lock release configuration DU (see FIG. 61A). , not shown in detail) against the second carriage surface 8842. The user can now engage the carriage locking lever 8858 and pivot it around the pin 8119 into the stepped region 8860 of the locking body 8114, and the first lever surface 8862 and the first carriage surface 8840 The locking body 8114 can move relative to the carriage 8832 along the second axis A2 when there is no contact between the second lever surface 8864 and the second carriage surface 8842. It can be done.

63A-63F, certain exemplary steps for securing a fixture 8050 at a surgical site ST by an eighth embodiment of an end effector 8040 utilizing a rotary drive tool 8048 are sequentially illustrated. There is. Starting from FIG. 63A, a surgical site ST is schematically shown, with a pilot hole 8046 already formed along the trajectory T. A rotary drive tool 8048 is shown secured to fixture 8050 and spaced from end effector 8040. Here, the protective cover 8350 of the retention mechanism 8664 is positioned in a second protective position U2 to expose the proximal entrance 8480 of the drive hole 8478 of the drive assembly 8082.

In FIG. 63B, the user operates the tool 8042 by inserting the working end 8470 of the tool 8042 (here defined by the distal tip 8050D of the fixture 8050) into the proximal entrance 8480 of the drive bore 8478. It is "top-loaded" into drive conduit 8462 and advanced through drive conduit 8462 along second axis A2 from distal outlet 8482 of drive bore 8478 toward surgical site ST. The axial catch AL defined by the retention feature 8664 remains in the released configuration ACR, while the protective cover 8350 is positioned in the second protective position U2, thereby locking the tool 8042 into the drive conduit. 8462 along the second axis A2 in a direction away from the surgical site ST. However, further movement towards the surgical site ST with respect to the drive conduit 8462 along the second axis A2 is caused between the second seat element 8794 of the tool body 8466 and the proximal carrier end 8694 of the carrier shaft 8422. is suppressed by the engagement of Again, the engagement of the second notch element 8796 of the rotary drive tool 8048 with the second notch 8696 of the carrier shaft 8422 (see FIGS. 51 and 57) defines a second rotary stop RL2 and thus , the rotary drive tool 8048 and the carrier shaft 8422 rotate simultaneously about the second axis A2.

In FIG. 63C, the protective cover 8350 of the retention mechanism 8664 has been pivoted to the first protective position U1, and the protective knob 8806 has rotated to lock the axial catch AL from the release configuration ACR (see FIG. 58C). Moving to form ACL (see Figure 58D). Here, relative movement between the drive assembly 8082 and the rotary drive tool 8048 along the second axis A2 is limited and the user uses the actuator 8166 of the rotary instrument 8080 to move the fixture 8050 onto the trajectory T. The tool 8042 can be driven through the manipulator assembly 8088 to advance it along the pilot hole 8046 of the surgical site ST. Again, the user can also use the manual interface 8094 without the actuator 8166, such as by a handle assembly inserted through the knob opening 8824 into the hexagonal hole 8848 (see FIGS. 61A-62B) of the rotary drive tool 8048. A force can be applied to drive tool 8042 along trajectory T.

In FIG. 63D, the user completes the placement of the fixture 8050 at the surgical site ST along the trajectory T. The protective cover 8350 of the retention mechanism 8664 has now returned to the second protective position U2 and the axial catch AL is in the released configuration ACR. Furthermore, the lock subassembly 8810 of the rotary drive tool 8048 is arranged in a power transfer lock configuration DL. However, in FIG. 63E, the locking subassembly 8810 has moved to the power transfer unlock configuration DU, thus releasing the rotary drive tool 8048 from the fixture 8050 and then driving the end effector 8040, as shown in FIG. 63F. It can be removed from conduit 8462.

Referring again to FIG. 63D, after the user completes placement of the fixture 8050 at the surgical site ST along the trajectory T, the actuator 8166 (or end effector 8050 another component of the fixture) in both directions (e.g., by driving actuator 8166 to maintain position without rotation) or unidirectionally (e.g., with the direction of rotation used to install fixture 8050). may be placed in a mode that limits or otherwise prevents rotation of drive conduit 8462 (by driving actuator 8166 to prevent rotation in the opposite direction). To this end, the actuator 8166 itself can be driven in a variety of ways, such as by adding additional It will be appreciated that components and/or locking features may also be used. Here, by suppressing the rotation of the drive conduit 8462, the rotation of the second seat element 8794 via the second rotational lock RL2 is also suppressed. Accordingly, when the locking subassembly 8810 is in the power transmission unlock configuration DU shown in FIG. The male threads 8120 of 8106 can be disengaged from the female threads 8122 (see FIG. 60) of the fixture 8050, thereby facilitating removal of the fixture 8050 shown in FIG. 63F.

Embodiments of the surgical systems 30, end effectors, and methods described herein are useful in a number of medical and/or surgical procedures, including, for example, when surgical robots 32 are utilized in minimally invasive surgical procedures such as spinal fusions. Provide benefits in relation to treatment. Specifically, the embodiments of the end effector described and illustrated herein provide different types of rotations along a second axis A2 via rotation about a first axis A1 from an actuator of a rotating instrument. It is understood that the first axis A1 is configured to facilitate rotation of the tool and may be the same as the second axis A2 or different from the second axis A2, as described above. Good morning. Additionally, it is understood that the manual interface provides the surgeon with the ability to rotate the tool about the second axis A2 via the manual application of torque and/or force to the handle assembly generated by the actuator of the rotating instrument. It will be. Furthermore, by positioning the manipulator assembly, the surgeon can apply a force to the end effector to advance the tool along trajectory T and according to second axis A2 while simultaneously engaging and rotating the input manipulator. After being enabled to drive the instrument and moving to the second manipulator assembly position P2 or otherwise presenting the manual interface, unobstructed access to the manual interface is provided to the surgeon. .

Those skilled in the art will appreciate that aspects of the embodiments described and illustrated herein can be interchanged or otherwise combined.

The terms "include," "includes," and "including" are the same as the terms "comprise," "comprises," and "comprising." It will be further understood that it has meaning. Additionally, terms such as "first," "second," "third," and the like are used herein in a non-limiting and descriptive manner to refer to specific structural features and components. It will be understood that it is used to distinguish between

In the above description, several configurations were discussed. However, the configurations discussed herein are not intended to be exhaustive or to limit the invention to particular forms. The terminology used is intended to be in the nature of words of description rather than limitation. Many modifications and variations are possible in light of the above teachings, and the invention may be practiced otherwise than as specifically described. Note that aspects of the technical idea that can be understood from the above embodiments are shown below.
[Aspect 1]
An end effector for driving a tool at a surgical site along a trajectory maintained by a surgical robot, the tool having an interface end and a working end, the end effector comprising:
a fixture adapted to be attached to the surgical robot;
an actuator coupled to the fixture and configured to generate rotational torque about a first axis;
drive assembly and
Equipped with
The drive assembly includes:
a gear train that converts rotation about the first axis from the actuator into rotation about a second axis;
a drive conduit supported for rotation about the second axis;
a first rotational lock operably attached to the drive conduit to releasably secure the tool for simultaneous rotation about the second axis;
an axial stop releasably securing the tool for simultaneous translation of the drive conduit along the trajectory maintained by the surgical robot;
Equipped with
The axial locking device is
a release configuration allowing relative movement between the drive assembly and the tool along the second axis;
a locking configuration that limits relative movement between the drive assembly and the tool along the second axis;
An end effector that is capable of operating between
[Aspect 2]
The end effector of aspect 1, wherein the drive conduit of the drive assembly defines a drive hole shaped to receive the working end of the tool along the second axis.
[Aspect 3]
The drive assembly defines a proximal inlet and an opposing distal outlet, and the drive conduit is interposed in communication between the proximal inlet and the distal outlet to maintain the axial engagement. When the stop is in the released configuration, the working end of the tool is inserted into the proximal inlet along the second axis and through the drive hole and out of the distal outlet into the surgical 3. The end effector according to aspect 2, being capable of advancing toward the site.
[Aspect 4]
4. The end effector of aspect 2 or 3, wherein at least a portion of the drive hole of the drive conduit defines the first rotational stop.
[Aspect 5]
the first rotational stop of the drive assembly is configured to engage at least a portion of the tool between the interface end and the working end when the axial stop is in the locked configuration; 5. The end effector of aspect 4, wherein the interface end of the tool is disposed proximal to the drive bore and the working end of the tool is disposed distal to the drive bore. .
[Aspect 6]
The end effector according to any one of aspects 1 to 5, wherein the first axis is different from the second axis.
[Aspect 7]
The end effector of any one of aspects 1-6, wherein the first axis is substantially orthogonal to the second axis.
[Aspect 8]
The end effector according to any one of aspects 1 to 5, wherein the first axis coincides with the second axis.
[Aspect 9]
The gear train of the drive assembly includes at least one reduction gear set interposed in rotational communication between the actuator and the drive conduit, thereby reducing rotation of the actuator about the first axis. 9. The end effector of any one of aspects 1-8, wherein rotation of the first rotational stop about the second axis occurs at a different speed.
[Aspect 10]
The drive assembly further includes a second rotational stop different from the first rotational stop, the second rotational stop being configured to rotate the rotational stop simultaneously about the second axis. operably attached to the drive conduit to releasably secure a second tool, the second rotational stop is disposed in rotational communication with the gear train, thereby 10. The end effector of aspect 9, wherein rotation of the rotational lock about the second axis occurs at a different rate than rotation of the first rotational lock about the second axis.
[Aspect 11]
11. The end of aspect 10, wherein rotation of the second rotational stop about the second axis occurs in a 1:1 ratio to rotation of the actuator about the first axis. effector.
[Aspect 12]
the gear train of the drive assembly includes a transmission interposed in rotational communication between the actuator and the drive conduit;
the transmission device includes a first gear set, a second gear set, and a conversion collar;
The conversion color is
a first collar position in which the conversion collar engages the first gear set to convert rotation between the actuator and the drive conduit at a first drive ratio;
a second collar position where the conversion collar engages the second gear set to convert rotation between the actuator and the drive conduit at a second drive ratio different from the first drive ratio; and
The end effector according to any one of aspects 1 to 11, wherein the end effector is arranged to move between the ends.
[Aspect 13]
the transmission further comprising a transmission linkage operably attached to the translation collar for simultaneous movement between the first collar position and the second collar position;
a switch, wherein the transmission linkage is arranged to engage at least a portion of the tool to move the conversion collar to the second collar position when the axial lock is in the locked configuration; 13. The end effector of aspect 12, defining a vessel.
[Aspect 14]
The transmission device includes a linkage biasing element arranged to move the conversion collar toward the first collar position when the axial lock moves from the locked configuration to the released configuration. The end effector according to aspect 13, further comprising:
[Aspect 15]
15. The end effector of any one of aspects 1-14, wherein the first rotational lock comprises a keyhole.
[Aspect 16]
15. The end effector of any one of aspects 1-14, wherein the first rotational stop comprises a spline hole.
[Aspect 17]
15. The end effector of any one of aspects 1-14, wherein the first rotational stop comprises a notch.
[Aspect 18]
18. The end effector of any one of aspects 1-17, wherein the axial stop comprises a spherical element.
[Aspect 19]
the axial stop comprises a slider element;
The slider element is
a first slider element position associated with the release configuration;
a second slider element position associated with the locking configuration;
18. The end effector according to any one of aspects 1 to 17, wherein the end effector is arranged to move relative to the second axis between.
[Aspect 20]
20. The end effector of aspect 19, wherein the slider element is positioned closer to the second axis at the second slider element position than at the first slider element position.
[Aspect 21]
the axial locking device includes a collet mechanism;
The collet mechanism is
a collet positioned to receive the tool along the second axis;
a collet tensioner coupled to the collet;
Equipped with
The collet tensioner is
a first tensioner position relative to the release configuration allowing relative movement between the tool and the collet;
a second tensioner position associated with the locking configuration in which relative movement between the tool and the collet is restricted;
18. The end effector according to any one of aspects 1 to 17, wherein the end effector is arranged to move between the ends.
[Aspect 22]
22. The end effector of aspect 21, wherein movement of the collet tensioner from the first tensioner position to the second tensioner position moves at least a portion of the collet radially inwardly toward the second axis. .
[Aspect 23]
further comprising a light source operably attached to the fixture;
23. The end effector of any one of aspects 1-22, wherein the light source is configured to emit light towards the surgical site.
[Aspect 24]
24. The end effector of aspect 23, wherein the light source comprises a laser diode.
[Aspect 25]
25. The end effector of aspect 23 or 24, wherein the light source is further configured to emit light along an optical path substantially aligned with the second axis.
[Aspect 26]
26. The end effector of any one of aspects 23-25, wherein the light source is configured to be removably attached to the drive conduit of the drive assembly.
[Aspect 27]
An end effector for driving a tool at a surgical site along a trajectory maintained by a surgical robot, the end effector comprising:
a fixture adapted to be attached to the surgical robot;
a rotating device comprising an actuator coupled to the fixture and configured to generate rotational torque about a first axis;
a gear train for converting rotation from the rotating equipment into rotation about a second axis different from the first axis, and releasably securing the tool for rotation about the second axis; a drive assembly comprising a connector configured to;
a grip for supporting a user's hand and arranged to cooperate with the rotating device and, when engaged by the user, drive the rotating device to rotate the tool about the second axis; an operating tool assembly comprising an input operating tool;
a manual interface in communication with the drive assembly and arranged to receive applied force from the user and convert it into rotational torque for rotating the tool about the second axis;
An end effector equipped with
[Aspect 28]
28. The end effector of aspect 27, wherein the manipulator assembly includes a frame that supports the grip and the input manipulator for movement relative to the rotating instrument between a plurality of manipulator assembly positions.
[Aspect 29]
the manipulator assembly further comprises a retainer coupled to the frame;
one of the retainer and the rotary device includes a plunger that is selectively movable between a locked position and an unlocked position;
the other of the retainer and the rotating device includes a catch having a plurality of receiving portions;
29. The end effector of aspect 28, wherein each of the plurality of receptacles is shaped to receive the plunger in the locked position to define one of the manipulator assembly positions.
[Aspect 30]
the catch has a substantially annular shape,
30. The end effector of aspect 29, wherein the receptacles are radially spaced from each other about the catch.
[Aspect 31]
the retainer includes a release lever associated with the plunger;
31. The end effector of aspect 29 or 30, wherein the release lever is arranged to facilitate movement of the plunger between the locked position and the unlocked position when engaged by the user. .
[Aspect 32]
32. The end effector of any one of aspects 29-31, wherein the frame supports the manipulator assembly for rotation relative to the rotary instrument between the plurality of manipulator assembly positions.
[Aspect 33]
The rotating device includes a journal,
The manipulator assembly includes a bearing surface operably attached to the frame, the bearing surface being arranged to engage the journal, thereby causing the manipulator assembly to rotate about the manipulating axis. 33. The end effector of aspect 32, wherein the end effector is selectively movable with respect to the rotating instrument between the plurality of manipulator assembly positions.
[Aspect 34]
34. The end effector according to aspect 33, wherein the operating axis coincides with the first axis.
[Aspect 35]
The frame of the manipulator assembly includes:
a first frame body coupled to the retainer for simultaneous movement between the plurality of manipulator assembly positions;
a second frame body supporting the grip and the input operating tool so as to move between a plurality of grip positions relative to the first frame body;
The end effector according to aspect 33 or 34, comprising:
[Aspect 36]
The plurality of grip positions are
At least a portion of the second frame body restricts access to the manual interface, and when the input manipulator is engaged by the user, drives the rotary instrument to move the tool to the second shaft. a first grip position arranged for rotation about the first grip position;
the second frame body is in a spaced relationship with respect to the manual interface to facilitate receiving applied forces from the user to rotate the tool about the second axis; a second grip position to be placed;
36. The end effector according to aspect 35, comprising:
[Aspect 37]
Aspects 35 or 36, wherein the second frame body is arranged to move simultaneously with the first frame body between the plurality of manipulator assembly positions without relying on movement between the plurality of grip positions. End effector described in.
[Aspect 38]
The plurality of manipulator assembly positions are
a first manipulator assembly position positioned to drive the rotary instrument to rotate the tool about the second axis when the manipulator assembly is engaged by the user;
a second manipulator assembly position in which the manual interface is positioned to receive an applied force from the user to rotate the tool about the second axis;
The end effector according to aspect 28, comprising:
[Aspect 39]
further comprising an assembly sensor arrangement interposed between the rotating instrument and the operating tool assembly to determine a position of the operating tool assembly relative to the rotating instrument between the first and second operating tool assembly positions. The end effector according to aspect 38.
[Aspect 40]
40. The end effector of aspect 38 or 39, wherein the second axis intersects at least a portion of the manipulator assembly at the first manipulator assembly position.
[Aspect 41]
Aspects 38-40, wherein the grip of the manipulator assembly is substantially parallel to the second axis when the manipulator assembly is in one of the first and second manipulator assembly positions. The end effector according to any one of the above.
[Aspect 42]
42, wherein the grip of the manipulator assembly is substantially orthogonal to the second axis when the manipulator assembly is in one of the first and second manipulator assembly positions. The end effector according to any one of the items.
[Aspect 43]
43. The grip of the manipulator assembly is substantially parallel to the second axis when the manipulator assembly is in the other of the first and second manipulator assembly positions. end effector.
[Aspect 44]
The end effector of any one of aspects 38-43, wherein at least a portion of the handle assembly restricts access to the manual interface when the handle assembly is in the first handle assembly position. .
[Aspect 45]
Any of aspects 38-44, wherein movement from the first manipulator assembly position to the second manipulator assembly position facilitates access to the manual interface to receive an applied force from the user. The end effector according to item 1.
[Aspect 46]
46. According to any one of aspects 27 to 45, the manual interface comprises a head arranged to rotate about the second axis to receive rotational force applied from the user. end effector.
[Aspect 47]
further comprising a protective cover operably attached to the drive assembly;
The protective cover is
a first protective position in which the second axis intersects at least a portion of the protective cover to limit access to the manual interface;
a second protective position in which the protective cover is spaced from the second shaft to facilitate access to the manual interface;
47. The end effector of aspect 46, wherein the end effector is arranged to move relative to the second axis between.
[Aspect 48]
the protective cover comprises a protector defining a protective pocket;
48. The end effector of aspect 47, wherein the protective pocket is shaped to accommodate at least a portion of the manual interface in the first protective position.
[Aspect 49]
Aspect 48, wherein the protector comprises a protection hinge operably attached to the drive assembly such that the protector pivots about a protection axis between the first protection position and the second protection position. End effector as described.
[Aspect 50]
50. The end effector of aspect 49, wherein the protection axis is disposed substantially perpendicular to the second axis.
[Aspect 51]
51. The end effector of aspect 49 or 50, wherein the protection axis is disposed substantially orthogonal to the first axis.
[Aspect 52]
the manipulator assembly further comprising a frame that supports the grip and the input manipulator for rotation relative to the rotating device between a plurality of manipulator assembly positions;
the input manipulator of the manipulator assembly is arranged to move relative to the grip between a first input position and a second input position to control rotational torque generated by the rotating device; The end effector according to aspect 27.
[Aspect 53]
The operating tool assembly further includes an operating transmitter that cooperates with the input operating tool,
53. The end effector of aspect 52, wherein the rotary device further comprises a manipulation detector that determines a position of the manipulation emitter corresponding to movement of the input manipulator between the first and second input positions.
[Aspect 54]
interposed between the input operating tool and the operating transmitter to convert movement of the input operating tool between the first and second input positions into a corresponding movement of the operating transmitter. 54. The end effector of aspect 53, further comprising a linkage.
[Aspect 55]
The link mechanism includes a fork-shaped body that cooperates with the operating transmitter,
the fork feature is arranged to rotate about the first axis as the manipulator assembly moves between the plurality of manipulator assembly positions;
55. The end effector of aspect 54, wherein the fork feature is further arranged to translate along the first axis as the input manipulator moves between the first and second input positions.
[Aspect 56]
the fork-shaped body defining an inner sliding contact surface and a pair of inner blocking surfaces;
further comprising a carrier that supports the operation transmitter,
the carrier defines an outer sliding contact surface and a pair of outer blocking surfaces;
The outer sliding contact surface engages the inner sliding contact surface of the fork-shaped body to enable rotation of the fork-shaped body about the first axis without moving the carrier. west,
the pair of outer blocking surfaces each engage the pair of inner blocking surfaces of the fork-shaped body to facilitate simultaneous translation of the fork-shaped body and the carrier along the first axis; The end effector according to aspect 55.
[Aspect 57]
the rotating device defines a slot located adjacent to the manipulation detector;
the carrier is in the slot for translation in response to a corresponding translation of the fork-shaped body along the first axis caused by movement of the input manipulator between the first and second input positions; 57. The end effector of aspect 56, further comprising a boss supported along.
[Aspect 58]
58. According to any one of aspects 27-57, further comprising a handle assembly for attachment to the manual interface, whereby the force applied to the handle assembly rotates the tool about the second axis. End effector as described.
[Aspect 59]
59. The end effector of aspect 58, wherein the handle assembly is releasably attachable to the manual interface.
[Aspect 60]
the manual interface comprises a head arranged to rotate about the second axis;
According to aspect 58 or 59, the handle assembly comprises a power transmission configured to receive the head of the manual interface for simultaneous rotation in response to a force applied to the handle assembly by the user. End effector as described.
[Aspect 61]
The handle assembly includes:
a handle body that receives a force applied by the user;
The handle body and the power transmission device are configured to simultaneously rotate about the second axis in a third rotational direction, and the power transmission device is configured to rotate relative to the handle body in the third rotational direction. a ratchet mechanism interposed between the handle body and the power transmission device to stop rotation in a fourth opposite rotational direction;
61. The end effector of aspect 60, further comprising:
[Aspect 62]
the drive assembly further comprising a clutch mechanism interposed between the manual interface and the gear train;
The clutch mechanism is
a first mode in which rotational torque generated by the rotating equipment is transmitted by the gear train to rotate the tool about the second axis but not to rotate the head of the manual interface;
a second mode in which a force applied to the handle assembly simultaneously rotates the head and the power transmission to transmit torque through the gear train and rotate the tool about the second axis;
62. The end effector of aspect 60 or 61, wherein the end effector is operable between.
[Aspect 63]
63. The end effector of aspect 62, wherein the clutch mechanism moves from the first mode to the second mode in response to a force applied to the handle assembly by the user.
[Aspect 64]
64. The end effector of aspect 62 or 63, wherein the clutch mechanism further comprises a clutch biasing element arranged to move the clutch mechanism from the second mode toward the first mode.
[Aspect 65]
further comprising a differential assembly interposed between the rotary device, the connector, and the manual interface;
The differential assembly includes:
A rotational torque generated by the rotating equipment is transmitted by the differential assembly to the connector, causing the tool to rotate about the second axis, and to the head of the manual interface, and is transmitted to the head of the manual interface. a haptic mode that provides haptic torque feedback;
Rotational torque generated by the rotating equipment is transmitted by the differential assembly to the connector to rotate the tool about the second axis but not to transmit rotational torque to the head of the manual interface. a first abort mode;
Rotational torque applied to the head of the manual interface is transmitted by the differential assembly to the connector, causing the tool to rotate about the second axis, but not transmitting rotational torque to the rotating equipment. The second abort mode and
65. The end effector according to any one of aspects 60-64, wherein the end effector is operable between.
[Aspect 66]
The differential assembly includes:
an interface side gear arranged to be rotationally linked with the manual interface;
a connector-side gear arranged to rotate in conjunction with the connector;
a differential case arranged to be rotationally linked with the rotating device;
a pinion shaft operatively mounted to the differential case for simultaneous movement;
a pair of pinion gears each supported by the pinion shaft and arranged to mesh with the interface side gear and the connector side gear;
66. The end effector according to aspect 65, comprising:
[Aspect 67]
further comprising a differential housing operably attached to the drive assembly;
67. The end effector of aspect 66, wherein the differential housing defines a differential chamber shaped to accommodate at least a portion of the differential case of the differential assembly.
[Aspect 68]
the differential housing defines a differential axis;
when the differential assembly operates in the first discontinued mode, rotation of the differential case relative to the differential housing about the differential axis is possible;
68. The end effector of aspect 67, wherein rotation of the differential case relative to the differential housing about the differential axis is inhibited when the differential assembly operates in the second abort mode.
[Aspect 69]
69. The end effector of aspect 68, wherein rotation of the interface gear and the connector gear about the differential axis is possible when the differential assembly operates in the second abort mode.
[Aspect 70]
70. The end effector of aspect 69, wherein rotation of the connector side gear about the differential axis is possible when the differential assembly operates in the first abort mode.
[Aspect 71]
71. The end effector of aspect 69 or 70, wherein rotation of the interface gear about the differential axis is inhibited when the differential assembly operates in the first abort mode.
[Aspect 72]
the pinion shaft of the differential assembly defines a pinion axis;
72. The end effector of any one of aspects 68-71, wherein the pinion gears are each capable of rotating about the pinion axis.
[Aspect 73]
73. The end effector of aspect 72, wherein the pinion axis is substantially orthogonal to the differential axis.
[Aspect 74]
74. The end effector of any one of aspects 68-73, wherein the differential axis coincides with the second axis.
[Aspect 75]
The gear train of the drive assembly includes at least one reduction gear set interposed in rotational communication between the rotating equipment and the connector, such that rotation of the rotating equipment is independent of rotation of the tool. 75. The end effector according to any one of aspects 27-74, which occurs at different speeds.
[Aspect 76]
76. The end effector of aspect 75, wherein the at least one reduction gear set comprises a planetary gear set.
[Aspect 77]
the gear train of the drive assembly is interposed in rotational communication between the rotating device and the connector to convert rotation about the first axis to rotation about the second axis; 28. The end effector of aspect 27, comprising at least one bevel gear set.
[Aspect 78]
78. The end effector of aspect 77, wherein the bevel gear set comprises a reduction gear set configured such that rotation of the rotating equipment occurs at a different speed than rotation of the tool.
[Aspect 79]
The gear train of the drive assembly further comprises at least one reduction gear set interposed in rotational communication between the rotary equipment and the bevel gear set, such that rotation of the rotary equipment reduces rotation of the tool. 78. The end effector of aspect 77, wherein the end effector occurs at a different speed than the end effector.
[Aspect 80]
The gear train of the drive assembly further includes at least one reduction gear set interposed in rotational communication between the bevel gear set and the connector, such that rotation of the rotating equipment is coupled to rotation of the tool. 78. The end effector according to aspect 77, wherein the ``s'' occur at different rates.
[Aspect 81]
81. The end effector of aspect 80, wherein the gear train of the drive assembly further comprises at least one auxiliary gear set interposed in rotational communication between the rotary instrument and the bevel gear set.
[Aspect 82]
82. The end effector of any one of aspects 27-81, further comprising a guide hole defined through the manual interface and the connector of the drive assembly to receive a guidewire.
[Aspect 83]
83. The end effector of any one of aspects 27-82, further comprising a coupler operably attached to the rotating equipment and configured to releasably secure the drive assembly to the rotating equipment.
[Aspect 84]
the drive assembly to facilitate selectively positioning the second axis relative to the rotating instrument along different trajectories selectively maintained by the surgical robot; 84. The end effector of aspect 83, configured to secure in multiple orientations with respect to the rotating equipment.
[Aspect 85]
The plurality of directions are
a reference orientation defined between the second axis of the drive assembly and a reference portion of the fixture;
a first orientation defined by rotation of the drive assembly relative to the rotating instrument about the first axis in a first direction of rotation;
a second orientation defined by rotation of the drive assembly relative to the rotating equipment about the first axis in a second rotational direction that is different from the first rotational direction;
85. The end effector of aspect 84, comprising:
[Aspect 86]
86. The end effector of aspect 84 or 85, further comprising an orientation sensor arrangement interposed between the rotating equipment and the drive assembly to determine the orientation of the drive assembly with respect to the rotating equipment.
[Aspect 87]
The orientation sensor arrangement body is
an orientation transmitter operably attached to the drive assembly;
an orientation detector operably attached to the rotating equipment to determine a position of the orientation emitter corresponding to the orientation of the drive assembly relative to the rotating equipment;
87. The end effector according to aspect 86, comprising:
[Aspect 88]
88. The end effector of any one of aspects 27-87, wherein the second axis intersects the first axis.
[Aspect 89]
89. The end effector of any one of aspects 27-88, wherein the second axis is substantially orthogonal to the first axis.
[Aspect 90]
An end effector for driving a tool at a surgical site along different trajectories selectively maintained by a surgical robot, the end effector comprising:
a fixture adapted to be attached to the surgical robot;
a rotating device comprising an actuator coupled to the fixture and configured to generate rotational torque about a first axis;
a gear train for converting rotation from the rotating equipment into rotation about a second axis different from the first axis, and releasably securing the tool for rotation about the second axis; a drive assembly comprising a connector configured to;
the drive assembly is operably attached to the rotating instrument for selectively positioning the second axis relative to the rotating instrument along different trajectories selectively maintained by the surgical robot; a coupler configured to releasably secure to the rotating device in a plurality of orientations;
An end effector equipped with
[Aspect 91]
The plurality of directions are
a reference orientation defined between the second axis of the drive assembly and a reference portion of the fixture;
a first orientation defined by rotation of the drive assembly relative to the rotating instrument about the first axis in a first direction of rotation;
a second orientation defined by rotation of the drive assembly relative to the rotating equipment about the first axis in a second rotational direction that is different from the first rotational direction;
91. The end effector of aspect 90, comprising:
[Aspect 92]
92. The end effector of aspect 90 or 91, further comprising an orientation sensor arrangement interposed between the rotating equipment and the drive assembly to determine the orientation of the drive assembly with respect to the rotating equipment.
[Aspect 93]
The orientation sensor arrangement body is
an orientation transmitter operably attached to the drive assembly;
an orientation detector operably attached to the rotating equipment to determine a position of the orientation emitter corresponding to the orientation of the drive assembly relative to the rotating equipment;
93. The end effector according to aspect 92, comprising:
[Aspect 94]
further comprising a manual interface in conjunction with the drive assembly;
94. Any one of aspects 90-93, wherein the manual interface is arranged to receive applied force from a user and convert it into a rotational torque for rotating the tool about the second axis. End effector described in.
[Aspect 95]
95. The end effector of aspect 94, further comprising a handle assembly for attachment to the manual interface, such that a force applied to the handle assembly rotates the tool about the second axis.
[Aspect 96]
96. The end effector of aspect 95, wherein the handle assembly is releasably attachable to the manual interface.
[Aspect 97]
the manual interface comprises a head arranged to rotate about the second axis;
According to aspect 95 or 96, the handle assembly comprises a power transmission configured to receive the head of the manual interface for simultaneous rotation in response to a force applied to the handle assembly by the user. End effector as described.
[Aspect 98]
The handle assembly includes:
a handle body that receives a force applied by the user;
The handle body and the power transmission device are configured to simultaneously rotate about the second axis in a third rotational direction, and the power transmission device is configured to rotate relative to the handle body in the third rotational direction. a ratchet mechanism interposed between the handle body and the power transmission device to stop rotation in a fourth opposite rotational direction;
98. The end effector of aspect 97, further comprising:
[Aspect 99]
the drive assembly further comprising a clutch mechanism interposed between the manual interface and the gear train;
The clutch mechanism is
a first mode in which rotational torque generated by the rotating equipment is transmitted by the gear train to rotate the tool about the second axis but not to rotate the head of the manual interface;
a second mode in which a force applied to the handle assembly simultaneously rotates the head and the power transmission to transmit torque through the gear train and rotate the tool about the second axis;
99. The end effector according to aspect 97 or 98, wherein the end effector is operable between.
[Aspect 100]
100. The end effector of aspect 99, wherein the clutch mechanism moves from the first mode to the second mode in response to a force applied to the handle assembly by the user.
[Aspect 101]
101. The end effector of aspect 99 or 100, wherein the clutch mechanism further comprises a clutch biasing element arranged to move the clutch mechanism from the second mode toward the first mode.
[Aspect 102]
further comprising a differential assembly interposed between the rotary device, the connector, and the manual interface;
The differential assembly includes:
A rotational torque generated by the rotating equipment is transmitted by the differential assembly to the connector, causing the tool to rotate about the second axis, and to the head of the manual interface, and is transmitted to the head of the manual interface. a haptic mode that provides haptic torque feedback;
Rotational torque generated by the rotating equipment is transmitted by the differential assembly to the connector to rotate the tool about the second axis but not to transmit rotational torque to the head of the manual interface. a first abort mode;
Rotational torque applied to the head of the manual interface is transmitted by the differential assembly to the connector, causing the tool to rotate about the second axis, but not transmitting rotational torque to the rotating equipment. The second abort mode and
102. The end effector according to any one of aspects 97-101, wherein the end effector is operable between.
[Aspect 103]
The differential assembly includes:
an interface side gear arranged to be rotationally linked with the manual interface;
a connector-side gear arranged to rotate in conjunction with the connector;
a differential case arranged to be rotationally linked with the rotating device;
a pinion shaft operatively mounted to the differential case for simultaneous movement;
a pair of pinion gears each supported by the pinion shaft and arranged to mesh with the interface side gear and the connector side gear;
103. The end effector of aspect 102, comprising:
[Aspect 104]
further comprising a differential housing operably attached to the drive assembly;
104. The end effector of aspect 103, wherein the differential housing defines a differential chamber shaped to accommodate at least a portion of the differential case of the differential assembly.
[Aspect 105]
the differential housing defines a differential axis;
when the differential assembly operates in the first discontinued mode, rotation of the differential case relative to the differential housing about the differential axis is possible;
105. The end effector of aspect 104, wherein rotation of the differential case relative to the differential housing about the differential axis is inhibited when the differential assembly operates in the second abort mode.
[Aspect 106]
106. The end effector of aspect 105, wherein rotation of the interface gear and the connector gear about the differential axis is possible when the differential assembly operates in the second abort mode.
[Aspect 107]
107. The end effector of aspect 106, wherein rotation of the connector side gear about the differential axis is possible when the differential assembly operates in the first abort mode.
[Aspect 108]
108. The end effector of aspect 106 or 107, wherein rotation of the interface gear about the differential axis is inhibited when the differential assembly operates in the first abort mode.
[Aspect 109]
the pinion shaft of the differential assembly defines a pinion axis;
109. The end effector of any one of aspects 105-108, wherein the pinion gears are each capable of rotating about the pinion axis.
[Aspect 110]
110. The end effector of aspect 109, wherein the pinion axis is substantially orthogonal to the differential axis.
[Aspect 111]
111. The end effector of any one of aspects 105-110, wherein the differential axis coincides with the second axis.
[Aspect 112]
112. The manual interface according to any one of aspects 94-111, wherein the manual interface comprises a head arranged to rotate about the second axis to receive a rotational force applied from the user. end effector.
[Aspect 113]
further comprising a protective cover operably attached to the drive assembly;
The protective cover is
a first protective position in which the second axis intersects at least a portion of the protective cover to limit access to the manual interface;
a second protective position in which the protective cover is spaced from the second shaft to facilitate access to the manual interface;
113. The end effector of aspect 112, wherein the end effector is arranged to move relative to the second axis between.
[Aspect 114]
the protective cover comprises a protector defining a protective pocket;
114. The end effector of aspect 113, wherein the protective pocket is shaped to accommodate at least a portion of the manual interface in the first protective position.
[Aspect 115]
Aspect 114, wherein the protector comprises a protection hinge operably attached to the drive assembly such that the protector pivots about a protection axis between the first protection position and the second protection position. End effector as described.
[Aspect 116]
116. The end effector of aspect 115, wherein the protection axis is disposed substantially orthogonal to the second axis.
[Aspect 117]
117. The end effector of aspect 115 or 116, wherein the protection axis is disposed substantially orthogonal to the first axis.
[Aspect 118]
118. The end effector of any one of aspects 94-117, further comprising a guide hole defined through the manual interface and the connector of the drive assembly to receive a guidewire.
[Aspect 119]
further comprising a control assembly;
The operating tool assembly includes:
a grip that supports the user's hand;
an input manipulator associated with the rotating device and arranged to, when engaged by a user, drive the rotating device and rotate the tool about the second axis;
a frame supporting the grip and the input manipulator for movement relative to the rotating device between a plurality of manipulator assembly positions;
The end effector according to any one of aspects 90 to 118, comprising:
[Aspect 120]
the manipulator assembly further comprises a retainer coupled to the frame;
one of the retainer and the rotary device includes a plunger that is selectively movable between a locked position and an unlocked position;
the other of the retainer and the rotating device includes a catch having a plurality of receiving portions;
120. The end effector of aspect 119, wherein each of the plurality of receptacles is shaped to receive the plunger in the locked position to define one of the manipulator assembly positions.
[Aspect 121]
the catch has a substantially annular shape,
121. The end effector of aspect 120, wherein the receptacles are radially spaced from each other about the catch.
[Aspect 122]
the retainer includes a release lever associated with the plunger;
122. The end effector of aspect 120 or 121, wherein the release lever is arranged to facilitate movement of the plunger between the locked position and the unlocked position when engaged by the user. .
[Aspect 123]
123. The end effector of any one of aspects 120-122, wherein the frame supports the manipulator assembly for rotation relative to the rotating instrument between the plurality of manipulator assembly positions.
[Aspect 124]
The rotating device includes a journal,
The manipulator assembly includes a bearing surface operably attached to the frame, the bearing surface being arranged to engage the journal, thereby causing the manipulator assembly to rotate about the manipulating axis. 124. The end effector of aspect 123, wherein the end effector is selectively movable with respect to the rotating instrument between the plurality of manipulator assembly positions.
[Aspect 125]
125. The end effector of aspect 124, wherein the operational axis coincides with the first axis.
[Aspect 126]
The frame of the manipulator assembly includes:
a first frame body coupled to the retainer for simultaneous movement between the plurality of manipulator assembly positions;
a second frame body supporting the grip and the input operating tool so as to move between a plurality of grip positions relative to the first frame body;
The end effector according to any one of aspects 123 to 125, comprising:
[Aspect 127]
The plurality of grip positions are
At least a portion of the second frame body restricts access to the manual interface, and the input manipulator, when engaged by the user, drives the rotary instrument to move the tool to the second frame body. a first grip position arranged for rotation about an axis;
the second frame body is in a spaced relationship with respect to the manual interface to facilitate receiving applied forces from the user to rotate the tool about the second axis; a second grip position to be placed;
127. The end effector of aspect 126, comprising:
[Aspect 128]
Aspects 126 or 127, wherein the second frame body is arranged to move simultaneously with the first frame body between the plurality of manipulator assembly positions without relying on movement between the plurality of grip positions. End effector described in.
[Aspect 129]
further comprising a manual interface in conjunction with the drive assembly;
the manual interface is arranged to receive applied force from a user and convert it into a rotational torque for rotating the tool about the second axis;
The plurality of manipulator assembly positions are
a first manipulator assembly position positioned to drive the rotary instrument to rotate the tool about the second axis when the manipulator assembly is engaged by the user;
a second manipulator assembly position in which the manual interface is positioned to receive an applied force from the user to rotate the tool about the second axis;
129. The end effector of any one of aspects 119-128, comprising:
[Aspect 130]
further comprising an assembly sensor arrangement interposed between the rotating instrument and the operating tool assembly to determine a position of the operating tool assembly relative to the rotating instrument between the first and second operating tool assembly positions. The end effector according to aspect 129.
[Aspect 131]
131. The end effector of aspect 129 or 130, wherein the second axis intersects at least a portion of the manipulator assembly at the first manipulator assembly position.
[Aspect 132]
Aspects 129-131, wherein the grip of the manipulator assembly is substantially parallel to the second axis when the manipulator assembly is in one of the first and second manipulator assembly positions. The end effector according to any one of the above.
[Aspect 133]
133. The grip of the manipulator assembly is substantially orthogonal to the second axis when the manipulator assembly is in one of the first and second manipulator assembly positions. The end effector according to any one of the items.
[Aspect 134]
Aspect 133, wherein the grip of the manipulator assembly is substantially parallel to the second axis when the manipulator assembly is in the other of the first and second manipulator assembly positions. end effector.
[Aspect 135]
The end effector of any one of aspects 129-134, wherein at least a portion of the handle assembly restricts access to the manual interface when the handle assembly is in the first handle assembly position. .
[Aspect 136]
Any of aspects 129-135, wherein movement from the first manipulator assembly position to the second manipulator assembly position facilitates access of the manual interface to receive an applied force from the user. The end effector according to item 1.
[Aspect 137]
the input manipulator of the manipulator assembly is arranged to move relative to the grip between a first input position and a second input position to control rotational torque generated by the rotating device; 137. The end effector according to any one of aspects 119 to 136.
[Aspect 138]
The operating tool assembly further includes an operating transmitter that cooperates with the input operating tool,
138. The end effector of aspect 137, wherein the rotary device further comprises a manipulation detector that determines a position of the manipulation emitter corresponding to movement of the input manipulator between the first and second input positions.
[Aspect 139]
interposed between the input operating tool and the operating transmitter to convert movement of the input operating tool between the first and second input positions into a corresponding movement of the operating transmitter. 139. The end effector of aspect 138, further comprising a linkage.
[Aspect 140]
The link mechanism includes a fork-shaped body that cooperates with the operating transmitter,
the fork feature is arranged to rotate about the first axis as the manipulator assembly moves between the plurality of manipulator assembly positions;
140. The end effector of aspect 139, wherein the fork feature is further arranged to translate along the first axis as the input manipulator moves between the first and second input positions.
[Aspect 141]
the fork-shaped body defining an inner sliding contact surface and a pair of inner blocking surfaces;
further comprising a carrier that supports the operation transmitter,
the carrier defines an outer sliding contact surface and a pair of outer blocking surfaces;
The outer sliding contact surface engages the inner sliding contact surface of the fork-shaped body to enable rotation of the fork-shaped body about the first axis without moving the carrier. west,
the pair of outer blocking surfaces each engage the pair of inner blocking surfaces of the fork-shaped body to facilitate simultaneous translation of the fork-shaped body and the carrier along the first axis; 141. The end effector according to aspect 140.
[Aspect 142]
the rotating device defines a slot located adjacent to the manipulation detector;
the carrier is in the slot for translation in response to a corresponding translation of the fork-shaped body along the first axis caused by movement of the input manipulator between the first and second input positions; 144. The end effector of aspect 143, further comprising a boss supported along.
[Aspect 143]
The gear train of the drive assembly includes at least one reduction gear set interposed in rotational communication between the rotating equipment and the connector, such that rotation of the rotating equipment is independent of rotation of the tool. 143. The end effector of any one of aspects 90-142, which occurs at different speeds.
[Aspect 144]
144. The end effector of aspect 143, wherein the at least one reduction gear set comprises a planetary gear set.
[Aspect 145]
the gear train of the drive assembly is interposed in rotational communication between the rotating device and the connector to convert rotation about the first axis to rotation about the second axis; 91. The end effector of aspect 90, comprising at least one bevel gear set.
[Aspect 146]
146. The end effector of aspect 145, wherein the bevel gear set comprises a reduction gear set configured such that rotation of the rotating equipment occurs at a different speed than rotation of the tool.
[Aspect 147]
The gear train of the drive assembly further comprises at least one reduction gear set interposed in rotational communication between the rotary equipment and the bevel gear set, such that rotation of the rotary equipment reduces rotation of the tool. 146. The end effector of aspect 145, wherein the end effector occurs at a different rate than the end effector.
[Aspect 148]
The gear train of the drive assembly further includes at least one reduction gear set interposed in rotational communication between the bevel gear set and the connector, such that rotation of the rotating equipment is coupled to rotation of the tool. 146. The end effector according to aspect 145, wherein the ``s'' occur at different rates.
[Aspect 149]
149. The end effector of aspect 148, wherein the gear train of the drive assembly further comprises at least one auxiliary gear set interposed in rotational communication between the rotary instrument and the bevel gear set.
[Aspect 150]
150. The end effector of any one of aspects 90-149, wherein the second axis intersects the first axis.
[Aspect 151]
151. The end effector of any one of aspects 90-150, wherein the second axis is substantially orthogonal to the first axis.
[Aspect 152]
An end effector for guiding a tool toward a surgical site along a trajectory maintained by a surgical robot, the tool comprising a first tool and a second tool different from the first tool. In the end effector, including,
a fixture adapted to be attached to the surgical robot;
a rotating device comprising an actuator coupled to the fixture and configured to generate rotational torque about a first axis;
a gear train for converting rotation about the first axis from the rotary device into rotation about a second axis; a gear train in rotational communication with the gear train to rotate the second axis at a first drive ratio; a first rotational stop arranged to releasably secure the first tool for simultaneous rotation therearound; a second rotational lock arranged to releasably secure the second tool for simultaneous rotation about the second axis at a drive ratio of and maintained by the surgical robot. a drive assembly comprising an axial stop releasably securing one of the first tool and the second tool for simultaneous translation along the trajectory;
Equipped with
The axial locking device is
a release configuration allowing relative movement between the drive assembly and the fixed tool along the second axis;
a locking configuration in which relative movement between the drive assembly and the fixed tool along the second axis is restricted;
An end effector that can operate between.
[Aspect 153]
An end effector for driving a tool at a surgical site along a trajectory maintained by a surgical robot, the tool comprising a first tool and a second tool different from the first tool. In the end effector,
a fixture adapted to be attached to the surgical robot;
a rotating device comprising an actuator coupled to the fixture and configured to generate rotational torque about a first axis;
a gear train for converting rotation from the rotating equipment into rotation about a second axis different from the first axis; a gear train for rotating the first tool and the second tool for rotation about the second axis; a drive assembly comprising a connector configured to releasably secure one of the tools of the invention and a transmission interposed for rotational communication between the rotating device and the connector;
Equipped with
the transmission device includes a first gear set, a second gear set, and a conversion collar;
The conversion color is
a first collar position in which the conversion collar engages the first gear set to convert rotation between the rotating device and the connector at a first drive ratio;
a second collar position in which the conversion collar engages the second gear set to convert rotation between the rotating equipment and the connector at a second drive ratio that is different than the first drive ratio; and
An end effector that is arranged to move between.
[Aspect 154]
the transmission further comprising a transmission linkage operably attached to the translation collar for simultaneous movement between the first collar position and the second collar position;
The transmission linkage engages at least a portion of the second tool to move the conversion collar to the second collar position when the second tool is secured to the connector of the drive assembly. 154. The end effector of aspect 153, defining a switch disposed in such a manner.
[Aspect 155]
155. The end effector of aspect 154, wherein the transmission further comprises a linkage biasing element arranged to move the conversion collar toward the first collar position.
[Aspect 156]
156. The end effector of aspect 155, wherein the switch is arranged to move the conversion collar to the first collar position when the first tool is secured to the connector of the drive assembly.
[Aspect 157]
A method of forming a pilot hole in a surgical site along a trajectory maintained by a surgical robot, the method comprising:
attaching an end effector to the surgical robot that supports an actuator, a drive assembly, a manual interface, and a manipulator assembly;
attaching a rotary cutting tool to the drive assembly along a second axis;
aligning the second axis with the trajectory to position the rotary cutting tool at the surgical site;
engaging the manipulator assembly to generate a rotational torque about a first axis by the actuator and converting the torque about the first axis from the actuator by the drive assembly to generate the rotational torque. rotating a cutting tool about the second axis;
advancing the rotary cutting tool along the trajectory at the surgical site to a first depth;
ceasing rotation about the first axis;
positioning the manipulator assembly to present the manual interface;
applying a force to the manual interface to rotate the rotary cutting tool about the second axis;
advancing the rotary cutting tool along the trajectory at the surgical site to a second depth that is greater than the first depth;
method including.
[Aspect 158]
A method of placing a fixture at a surgical site along a trajectory maintained by a surgical robot, the method comprising:
attaching an end effector to the surgical robot that supports an actuator, a drive assembly, a manual interface, and a manipulator assembly;
attaching a tool to the drive assembly along a second axis;
attaching the fixture to the tool;
aligning the second axis with the trajectory to position the fixture adjacent the surgical site;
engaging the handle assembly to generate a rotational torque about a first axis by the actuator and converting the torque about the first axis from the actuator by the drive assembly to drive the tool; and rotating the fixture about the second axis;
advancing the tool and the fixture along the trajectory at the surgical site to a first depth;
ceasing rotation about the first axis;
positioning the manipulator assembly to present the manual interface;
applying a force to the manual interface to rotate the tool and the fixture about the second axis;
advancing the fixture along the trajectory at the surgical site to a second depth that is greater than the first depth;
method including.
[Aspect 159]
A method of placing first and second fixtures at a surgical site along respective first and second trajectories maintained by a surgical robot, the method comprising:
attaching an end effector to the surgical robot that supports an actuator, a drive assembly, a manual interface, and a manipulator assembly;
attaching a tool to the drive assembly along a second axis;
attaching the first fixture to the tool;
aligning the second axis with the first trajectory to position the first fixture adjacent the surgical site;
engaging the handle assembly to generate a rotational torque about a first axis by the actuator and converting the torque about the first axis from the actuator by the drive assembly to drive the tool; and rotating the first fixture about the second axis;
advancing the tool and the first fixture along the first trajectory at the surgical site to a first depth;
ceasing rotation about the first axis;
positioning the manipulator assembly to present the manual interface;
applying a force to the manual interface to rotate the tool and the first fixture about the second axis;
advancing the tool and the first fixture along the first trajectory at the surgical site to a second depth that is greater than the first depth;
releasing the first fixture from the tool;
attaching the second fixture to the tool;
aligning the second axis with the second trajectory to position the second fixture adjacent the surgical site;
engaging the manipulator assembly to generate rotational torque about the first axis by the actuator;
converting torque about the first axis from the actuator by the drive assembly to rotate the tool and the second fixture about the second axis;
advancing the tool and the second fixture along the second trajectory at the surgical site to a third depth;
ceasing rotation about the first axis;
positioning the manipulator assembly to present the manual interface;
applying a force to the manual interface to rotate the tool and the second fixture about the second axis;
advancing the tool and the second fixture along the second trajectory at the surgical site to a fourth depth that is greater than the third depth;
method including.

Claims (15)

An end effector for driving a tool at a surgical site along a trajectory maintained by a surgical robot, the tool having an interface end and a working end, the end effector comprising:
a fixture adapted to be attached to the surgical robot;
an actuator coupled to the fixture and configured to generate rotational torque about a first axis;
comprising a drive assembly and
The drive assembly includes:
a gear train that converts rotation about the first axis from the actuator into rotation about a second axis;
a drive conduit supported for rotation about the second axis;
a first rotational stop attached to the drive conduit to releasably secure the tool and rotate about the second axis with the secured tool;
an axial stop releasably securing the tool for simultaneous translation with the drive conduit along the trajectory maintained by the surgical robot;
Equipped with
the gear train of the drive assembly includes a transmission interposed in rotational communication between the actuator and the drive conduit;
the transmission device includes a first gear set, a second gear set, and a conversion collar;
The conversion color is
a first collar position in which the conversion collar engages the first gear set to convert rotation between the actuator and the drive conduit at a first drive ratio;
a second collar position where the conversion collar engages the second gear set to convert rotation between the actuator and the drive conduit at a second drive ratio different from the first drive ratio; and,
arranged to move between
The axial locking device is
a release configuration allowing relative movement between the drive assembly and the tool along the second axis;
a locking configuration that limits relative movement between the drive assembly and the tool along the second axis;
An end effector that can be operated by moving or deforming between. The end effector of claim 1, wherein the drive conduit of the drive assembly defines a drive hole shaped to receive the working end of the tool along the second axis. The drive assembly defines a proximal inlet and an opposing distal outlet, and the drive conduit is interposed in communication between the proximal inlet and the distal outlet to maintain the axial engagement. When the stop is in the released configuration, the working end of the tool is inserted into the proximal inlet along the second axis and through the drive hole and out of the distal outlet into the surgical 3. The end effector of claim 2, wherein the end effector is capable of advancing toward the site. 4. The end effector of claim 2 or 3, wherein at least a portion of the drive hole of the drive conduit defines the first rotational stop. the first rotational stop of the drive assembly is configured to engage at least a portion of the tool between the interface end and the working end when the axial stop is in the locked configuration; 5. The end of claim 4, wherein the end of the tool is shaped such that the interface end of the tool is disposed proximal to the drive bore and the working end of the tool is disposed distal to the drive bore. effector. The end effector according to any one of claims 1 to 5, wherein the first axis is different from the second axis. The end effector according to any one of claims 1 to 6, wherein the first axis is orthogonal to the second axis. The end effector according to any one of claims 1 to 5, wherein the first axis coincides with the second axis. The gear train of the drive assembly includes at least one reduction gear set interposed in rotational communication between the actuator and the drive conduit, thereby reducing rotation of the actuator about the first axis. An end effector according to any preceding claim, wherein rotation of the first rotational stop about the second axis occurs at a different speed. the drive assembly further comprising a second rotational stop different from the first rotational stop, the second rotational stop releasably securing a second tool; the second rotational lock is mounted on a carrier shaft supported for rotation about the second axis and rotates about the second axis with the fixed second tool; , arranged in rotational communication with the gear train, such that rotation of the second rotational lock about the second axis causes rotation of the second rotational lock to rotate around the second axis of the first rotational lock. 10. The end effector of claim 9, wherein the end effector is configured to occur at a different speed than the rotation about the end effector. 11. The rotation of the second rotational stop about the second axis occurs in a 1:1 ratio to the rotation of the actuator about the first axis. end effector. the transmission further comprising a transmission linkage operably attached to the translation collar for simultaneous movement between the first collar position and the second collar position;
a switch, wherein the transmission linkage is arranged to engage at least a portion of the tool to move the conversion collar to the second collar position when the axial lock is in the locked configuration; Define the vessel;
The transmission device includes a linkage biasing element arranged to move the conversion collar toward the first collar position when the axial lock moves from the locked configuration to the released configuration. The end effector according to any one of claims 1 to 11, further comprising: the axial stop comprises a slider element;
The slider element is
a first slider element position that is the position of the slider element when taking the released configuration;
a second slider element position that is the position of the slider element when taking the locking configuration;
arranged to move relative to the second axis between
An end effector according to any preceding claim, wherein the slider element is located closer to the second axis at the second slider element position than at the first slider element position. the axial locking device includes a collet mechanism;
The collet mechanism is
a collet positioned to receive the tool along the second axis;
a collet tensioner coupled to the collet;
Equipped with
The collet tensioner is
a first tensioner position, which is the position of the collet tensioner when assuming the release configuration, in which relative movement between the tool and the collet is possible;
a second tensioner position that is a position of the collet tensioner when assuming the locking configuration in which relative movement between the tool and the collet is restricted;
arranged to move between
14. Movement of the collet tensioner from the first tensioner position to the second tensioner position causes at least a portion of the collet to move radially inwardly toward the second axis. The end effector according to item 1. further comprising a light source movably attached to the fixture and configured to emit light toward the surgical site;
An end effector according to any preceding claim, wherein the light source is further configured to emit light along an optical path aligned with the second axis.